LB 

-3411 



TREASURY DEPARTMENT 
UNITED STATES PUBLIC HEALTH SERVICE 



PUBLIC HEALTH BULLETIN No. 77 

JUNE, 1916 



RURAL SCHOOL SANITATION 

INCLUDING PHYSICAL AND MENTAL STATUS OF SCHOOL 
CHILDREN IN PORTER COUNTY, INDIANA 



By 

TALIAFERRO CLARK 

Surgeon, United States Public Health Service 

GEORGE L. COLLINS 

Surgeon, United States Public Health Service 

and 

W. L. TREADWAY 
Assistant Surgeon, United States Public Health Service 



PREPARED BY DIRECTION OF THE SURGEON GENERAL 




WASHINGTON 
GOVERNMENT PRINTING OFFICE 

1916 



Monograph 




Class 



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Rnnk ■ J 



cT.r 



TREASURY DEPARTMENT 
UNITED STATES PUBLIC HEALTH SERVICI 



PUBLIC HEALTH BULLETIN No. 77 

JUNE, 1916 



RURAL SCHOOL SANITATION 

INCLUDING PHYSICAL AND MENTAL STATUS OF SCHOOL 
CHILDREN IN PORTER COUNTY, INDIANA 



By 

TALIAFERRO CLARK 

Surgeon, United States Public Health Service 

GEORGE L. COLLINS 

Surgeon, United States Public Health Service 
and 

W. L. TREADWAY 

Assistant Surgeon, United States Public Health Service 




PREPARED BY DIRECTION OF THE SURGEON GENERAL 




WASHINGTON 

GOVERNMENT PRINTING OFFICE 

1916 



C55 



ADDITIONAL COPIES 

OF THIS PUBLICATION MAT BE PROCURED FROM 

THE SUPERINTENDENT OF DOCUMENTS 

GOVERNMENT PRINTING OFFICE 

WASHINGTON, D. C. 

AT 

15 CENTS PER COPV 



SEP 16 1916 



CONTENTS. 



-^ 



*> 

^ 

rage. 

Introduction 7 

PART I. — Sanitary survey of rural school locations and buildings 9 

General considerations 9 

School locations 10 

Privies and soil pollution 13 

Inside toilets 13 

Outside toilets or privies 15 

School buildings 20 

Number and construction 20 

State of repair 23 

Fire protection 23 

Water supply and lavatory facilities 25 

Classroom equipment - 30 

Classroom walls 30 

Floors 30 

School desks - 31 

Window shades 32 

Blackboards 33 

Daylight illumination of classrooms 35 

Securing an abundance of illumination 35 

Position of illumination source with respect to desk arrangement 40 

Diffusion of light and avoidance of glare 41 

Regulation of intensity of classroom illumination 45 

Heating of classrooms 45 

Efficiency of different types of heating apparatus 46 

Temperature regulation in classrooms 50 

Ventilation 53 

General considerations 53 

Humidity 57 

Dust 59 

Classroom cleaning in Porter County 60 

Elimination of odors from classrooms 61 

Other measures for securing outside air conditions 61 

Cloakroom accommodations in rural schools 62 

Janitor service 63 

PART II. — Physical fitness of rural school children 64 

Introductory observations 64 

Physical data 67 

Height and weight 67 

Mean height and weight 68 

Racial differences in physical development 70 

Vital capacity 74 

Chest expansion 76 

Dynamometer tests 76 

Cephalic index 76 

Pulse and respiration rate 78 

Nutrition , , , . . 78 

3 



4 CONTENTS. 

PART II. — Physical fltuess of rural school children — Continued. Page. 

Defects and diseases found 80 

Circulatory system 82 

Deformities of the extremities 82 

Defective hearing 82 

Nervous system 85 

Defects of nose and throat 85 

Diseases of the lungs 86 

Diseases of the skin 86 

Diseases of the teeth 86 

Speech defects 88 

Spinal curvature and faulty posture 88 

Hernia. 89 

Defects of vision 90 

Goiter 92 

PART III.^ — Mental status of rural school children 94 

History of tests 94 

Method of examination and grading 96 

Results of mental examination in Porter County 96 

Limits of normality 97 

Classification of retarded and exceptionally retarded children 97 

Retarded children 98 

Defects associated with mental retardation 98 

Other causes of mental retardation 100 

Care of retarded children 101 

Exceptionally retarded children 101 

Defects associated with exceptional retardation 101 

Characteristics 102 

Causes 102 

Number 103 

Care of mental defectives in Indiana 103 

Education of feebleminded 103 

Mental deficiency and its relation to the community 104 

Other mental conditions which require supervision 104 

Epileptics 104 

Juvenile delinquent 105 

Summary 107 

Sanitary survey. . ^ 107 

Physical status of school children 108 

Mental status 110 

Conclusions , Ill 

Recommendations 112 

Index 115 

Related publications 126 

TABLES. 

1. Atmospheric conditions in classrooms of Porter County 50 

2. Rate of air exchange 55 

3. Age distribution of rural school children 65. 

4. Mean height and weight 68 

5. Mean physical measurements of all rural school children in county com- 

pared with those of foreign birth 71 

6. Physical defects found 80 

7. Decree of impairment of hearing in those with defective hearing , 63 



CONTENTS. ^ 5 

Page. 

8. Auditor}' defects in school children 84 

9. Snellen chart visual test readings in 169 cases of faulty refraction 90 

10. Defects of vision 91 

11. Mental and chronological ages of 109 French school children examined by 

Binet and Simon 94 

12. Mental and chronological ages of American school children examined by 

Goddard 95 

13. Chronological and mental ages of Porter County rural school children 96 

FIGURES. 

1. A stationary sanitary privy with cement vault 16 

2. An L. R. S. privy ^vith tanks of concrete 17 

3. Girls' privy at Porter County school 19 

4. Type of "pit privy, ' ' ventilated and screened for privacy 20 

5. Shallow driven well with trough for drainage of waste water 27 

6. School well surrounded by shallow pit and board protection from surface 

drainage 28 

7. Type of jacketed stove 47 

CHARTS. 

1. Ratio of glass area to floor space 36 

2. Maximum and minimum ratios of glass area to fioor space 36 

3. Illumination of classroom, Grade V, C hesterton High School 37 

4. Illumination of classroom. Grade IV, Chesterton High School 38 

5. Relative position of windows 42 

6. Age distribution by sex for one-year age periods 66 

7. Mean vital capacity for one-year age periods 75 

8. Chest expansion by one-year age periods 76 

9. Average muscular strength of hands by one-year age periods 77 

10. Limits for normal, advanced, retarded, and deficient children 99 



RURAL SCHOOL SANITATION. 

INCLUDING PHYSICAL AND MENTAL STATUS OF SCHOOL 
CHILDREN IN PORTER COUNTY, IND. 



By Tamafeero Clark, George L. Collins, and W. L. Treadwat. 



Because of the recognized importance of school hygiene to public 
health and on request of the Indiana State Board of Health and 
the Porter County, Ind., health and school officials, a sanitary and 
medical survey of the rural schools of this county was made by the 
Public Health Service and completed on May 10, 1915. 

This investigation included a sanitary survey of school locations 
and buildings, a study of the physical fitness of rural school chil- 
dren, and mental tests of these children. On the basis of the results 
obtained recommendations were made to the health and school au- 
thorities of Porter County. It is believed that many of these are of 
general applicability, and they are, therefore, included in the follow- 
ing report of the results obtained in this investigation. 

7 



PART I. 



A SANITARY SURVEY OF RURAL SCHOOL LOCATIONS 

AND BUILDINGS. 

GENERAL CONSIDERATIONS. 

Porter County is the central of the three counties occupjdng the ex- 
treme northwestern corner of Indiana which are bordered by Lake 
Michigan on the north. It has an area of 415 square miles. Val- 
paraiso, the county seat, is located near the center of the county in 
latitude 41° 28", north, and in longitude 87° 04", west. The pop- 
ulation of Valparaiso in 1910 was 6,987. The schools of this city 
were not included in the survey. 

Topographically, Porter County ^ is comprised in the prairie sec- 
tion of Indiana. The county is covered with a sheet of glacial drift, 
ranging in thickness from 90 to 141 feet. From north to south the 
surface of the county comprises three distinct belts: The Calumet, 
the Morainic, and the Kankakee Basin regions. Of these, the 
Morainic is the most elevated. The Calumet in the north and the 
Kankakee in the south are lower and more level. 

The underlying rocks of this county are black Genesee shale of 
the Devonian age and are about 65 feet thick in the vicinity of 
Valparaiso. Beneath this shale is found Lower Helderburg and 
Niagara limestone strata in the order mentioned;. 

The geological formation of Porter County is interesting from 
a medical standpoint because the underlying rocks are of the same 
geological formation as has been found by one of the writers (Dr. 
Clark) in other regions associated wdth an extensive prevalence of 
simple thyroid enlargement. The wide prevalence of this condition 
observed during this survey will be discussed in greater detail in 
another place in this report. (See p. 92.) 

Artensian waters in this county have a very high lime content. 

The county is traversed by several trunk-line railways. The 
county roads are in good repair and of the macadam-gravel type. 
The schools of the county are so situated with respect to gravel 
roads that nearly all of them may be reached by automobile at any 
season of the year. The principal industry of the county is agricul- 
ture. 

1 The Geology of Lake and Porter Counties, Ind., by W. S. Blatchley. 



10 EUEAL SCHOOL SANITATION". 

Population. — The population of the county according to the 1910 
census was 20,540, classified as follows: Males, 10,999; females, 
9,541. These in turn are subdivided into the following classes: 
Native white persons of native parentage, 11,699; native white per- 
sons of foreign or mixed parentage, 5,880; foreign-born white per- 
sons, 2,939 ; negroes, 8. At the time of the census the foreign-born 
white persons comprised 14,5 per cent of the total population. The 
estimated population of the county at the completion of this survey. 
May 10, 1915, was 21,250. 

School poj)ulation. — The school population of the county, accord- 
ing to the annual school census completed subsequent to the termina- 
tion of this survey, was as follows: Total number of unmarried 
persons from 6 to 21 years of age in the county entitled to free 
school privileges, 3,933; namely, 2,078 males, 1,857 females. Of 
these there were 621 individuals 14 to 16 years of age. The total 
school enrollment for the year was 3,103, which included one pa- 
rochial school with an enrollment of 104 pupils. 

School attendance. — The average daily attendance for all rural 
public schools was 2,264 in the elementary schools, and 248 in the 
high schools. The city of Valparaiso is not included in this enu- 
meration. The total number of unmarried persons 6 to 21 years 
of age in the Valparaiso schools was 1,653. Of these 200 individuals 
were from 14 to 16 years of age. The total enrollment in the Valpa- 
raiso schools was 1,173. The average daily attendance in the Valpa- 
raiso schools, excluding one parochial school, during the year 1914^15, 
was 1,029. The average daily attendance was 835 in the elementary 
schools and 194 in the high school, exclusive of children attending the 
parochial school. 

Sociological data. — The average number of children in a family 
in the county was found to be 4.8 — 2.44 boys and 2.36 girls. 
Seventy- four children reported the occurrence of tuberculosis at 
some time or other in the family, and 129 children reported the 
death of their father, 141 the death of their mother, and 11 the death 
of both parents.^ 

Extent of survey. — In all 75 school buildings were surveyed and 
medical tests were made of the children attending 76 schools, includ- 
ing one parochial school, in the rural districts of the county. 

SCHOOL LOCATIONS. 

In a number of communities, although due consideration had been 
given to the construction of the school building, the school site had 
been unwisely selected. 

1 There were 2,488 pupils in the county, while 5,998 boys and 5,785 girls were reported 
in all families. 



SCHOOL LOCATIONS, 11 

Requirements. — The ideal requirements for school grounds are 
that they be of ample size to allow sufficient playground space for 
each pupil, protected from soil pollution by the establishment of 
sanitary privies, in a healthful location with sufficient elevation to 
insure good drainage, readily accessible to as large a part of the 
school population as possible, of ample proportions to furnish an 
unobstructed sky surface for illumination, and sufficiently isolated 
to avoid disturbing noises and other nuisances. 

Elevation. — With the exception of the Morainic belt, traversing 
the county slightly north of its center. Porter County is largely 
level prairie land. However, the elevation of school sites was found 
to be good in 24, fair in 24, and poor in 27 instances. 
' Drainage. — In some locations special efforts had been made to 
secure subdrainage of school grounds. This was found good in 40, 
fair in 26, and poor in but 9 instances. 

Walks. — The necessity for walks is apparent. One leading from 
the roadway to the school entrance is better than none at all, but 
others should lead to the fuel supply and to outside privies. Other- 
wise children are liable to refrain from attending to the calls of 
nature during inclement weather, and in so doing easily acquire the 
" constipated habit," which begets a condition of physical and mental 
hebetude incompatible with efficient school work. A large part of the 
dirt found in rural schools is brought into the classrooms on the 
children's feet. "Where there are no walks this condition is aggra- 
vated. 

Walks were observed at 30 schools in the county. Of these, 12 
were entrance walks only. In the other 18 schools there were walks 
leading to one or both privies. 

Shade. — At 17 schools the grounds are more or less shaded; in 
some cases sparsely, in a few others too thickly. The latter is es- 
pecially true of the Washington Township High School and Flint 
Lake School, Center township. Too much shade promotes dampness 
and materially limits the daylight illumination of the classrooms. 

Proximity to nuisarwes. — The location of 17 schools was in more 
or less close proximity to nuisances, as follows : Barnyards, 2 ; ceme- 
teries, 3; marshy land, 1; ponds, 2; railroads, 10; trolleys, 3. The 
grounds of the Flint Lake School of Center Township are adjacent 
to a pond, barnyard, and a trolley line, a conspicuous example of 
subjection to nuisances. 

The noise occasioned by the passage of trains over trunk-line rail- 
roads, near which so many schools in this county are located, must 
in time exercise an injurious effect upon teachers and pupils by ex- 
citing a condition of nervous irritability.^ 

* Notably Is this the case In the Frye School, Boone Township, Kouts School, Pleasant 
Township, and at the Old Porter and Porter Schools in Westchester Township. 



12 KUKAL SCHOOL SANITATION. 

While objections to cemeteries in the immediate vicinity of school- 
houses are largely sentimental, such proximity should be condemned 
from a sanitary viewpoint also because of the danger of contamina- 
tion of the school water supply. For this reason wells must often be 
located at an objectionable distance from these schoolhouses. 

Playgrounds. — The great value of regulated physical exercise and 
play in the o]3en air in connection with school work, which is other- 
wise a most sedentary occupation, is that it tends to overcome a one- 
sided development, increases the capacity and ability for work, in- 
tensifies the powers of observation, develops presence of mind, over- 
comes shyness and timidity so common in " shut-in " types of men- 
tality, increases body elasticity, and promotes graceful carriage. 
Furthermore, the great hope of the future is that, in making school 
life as attractive as possible through regulated physical exercises 
during the years of school life on ample playgrounds and with 
appropriate apparatus, truancy may be reduced in frequency and 
conditions which make for juvenile delinquency largely eliminated 
from community life. 

It is to be noted that in country districts children often have cer- 
tain home work to do which is erroneously considered exercise. The 
fallacy of this lies in the fact that physical exercise by children 
without the stimulus of mental enjoyment is work which is soon 
followed by fatigue. Carried further, it produces exhaustion, harm- 
ful in effect. Exercise of this character is usually followed by a one- 
sided physical development. 

The school grounds in the rural districts of Porter County, Ind., 
are without exception of ample area to admit the establishment of 
playgrounds. In a few schools, however, the areas are greatly re- 
stricted by reason of the topography, land unsuitable for other pur- 
poses having been chosen for the school site. Furthermore, an at- 
tempt had been made in but six schools to make any provision for 
playgrounds. 

Grounds* of sufficient area to permit an allowance of 30 square feet 
per pupil for playground purposes is considered ample in urban 
communities, where land is expensive. The necessity for so restricted 
an area is not apparent in rural communities. In Porter County the 
average school ground space per pupil, exclusive of area covered by 
the school building, was found to be 976.24 square feet. 

Accessibility to school population. — One of the cardinal rules to 
be observed in the selection of a school site is that it be easily accessi- 
ble to the greatest number of children. The average time spent by 
the children of Porter County in traveling to school was 18.8 min- 
utes, and few children spent more than three-quarters of an hour. 
Thus the schools are within a reasonable distance from the majority 
of the homes. 



SCHOOL LOCATIONS. 13 

Transportation of school children. — Free transportation of school 
children is practiced in 10 townships, 28 school busses being utilized. 
The number of children for whom free transportation to school was 
furnished by the county during 1914-1915 was 315, at a cost of 
$10,729.80, or $33 for each child. 

The abilit}'^ of the township to furnish free school transportation 
foreshadows a greater consolidation of schools, which is in accord- 
ance with the trend of modern practice in rural districts. By the 
consolidation of a number of the schools in any one community it 
becomes possible to employ a few well-equipped teachers in the place 
of several indifferently trained ones. Moreover, consolidation results 
in a saving in school lands, constructive material, and operating ex- 
penses. It also makes possible the erection of modern sanitary school 
buildings and the establishment of an efficient system of health super- 
vision without great additional expense to the taxpayer. Porter 
County is particularly well situated for school consolidation by reason 
of the good roads which traverse the county in every direction. 

The tj^pe of school bus used in the county, however, is open to 
criticism. During inclement weather the children are shut in by 
tightly-drawn curtains, are closely and promiscuously crowded to- 
gether under conditions which are favorable to the transfer of com- 
municable diseases, and offer opportunity to the vicious for immoral 
suggestion. The use of a number of motor-driven school busses on 
the good roads of Porter County is feasible. 

PRIVIES AND SOIL POLLUTION. 

Protection from soil pollution. — The prevention of soil pollution 
by the safe disposal of human excreta is one of the prime require- 
ments for the protection of health, because of the not uncommon 
presence in such excreta of the living agents of disease. In schools 
with sewer connection this dangerous matter is carried far away 
and soil pollution, therefore, so far as the school premises are con- 
cerned, is generally entirely obviated. At one and two room rural 
schools, however, evidences of soil pollution are too commonly met 
with. Some of them have no privy accommodations; at others, these 
are badly located, improperly constructed, and poorly maintained. 

INSroE TOILETS. 

Inside toilets were found at four schools. ^ At Chesterton, the 
toilets were connected with a sewer system, at Flint Lake and Hebron 
Schools with a cesspool, and at Porter with an incinerating apparatus. 

In the latter school the toilet is a decided nuisance. The accumu- 
lated excreta is incinerated but once a week. At the time of this in- 
spection, April 28, 1915, the odor from this accumulated filth was 

1 In all there were 16 seats for boys and 22 seats for girls. 



14 RURAL SCHOOL SANITATION. 

highly objectionable and could be detected in a classroom situated 
immediately above. The boys' urinal was connected with a cesspool 
beneath the basement floor. 

Location of inside toilets. — ^The desirability of locating sewered^ 
toilets in the basement or on classroom floors formerly received con- 
siderable attention. It is now known that the volatile emanations 
from sewers and toilets do not carry bacteria, thus removing the 
most serious objection which could be raised against the practice 
of placing them on the same floor with classrooms. The advantage 
of so locating these toilets is that they are more readily accessible, 
can be provided with daylight illumination, and permit a more di- 
rect supervision of both the toilets and the children who use them. 
Insanitary conditions are more readily detached, and therefore more 
promptly corrected, than in the case of toilets placed in the base- 
ment. Toilets, wherever located, should be adequately ventilated, 
however, and kept scrupulously clean to avoid objectionable odors. 

Toilets were located in the basement in three of the four schools 
mentioned above. In the Hebron School, however, the toilets were 
located on the classroom floors, one for each sex. 

Number of toilet seats. — The English have adopted the require- 
ment of five seats for each 100 boys, seven seats for each 100 girls 
and very young children. It is certainly more desirable to have a 
greater number of toilet seats than are actually necessary than too 
few. In new constructions this practice makes allowance for an 
increase in the population, avoids untoward accidents in the case 
of the very young, whose powers of inhibition are low, and culti- 
vates a habit of regular response to the demands of nature so essen- 
tial to perfect physical health. 

The height of the seats should be graduated from 11 to 12 inches 
for young children to 14 to 16 for those who are older. These re- 
quirements are equally applicable to outside privies. 

Toilet plmnhing and other coTisiderations. — Because of the 
thoughtlessness of the majority of children and the numbers in- 
volved, the plumbing of school buildings is often subjected to undue 
strain, a fact well recognized by most architects, who advise the use 
of fixtures and pipes of extra weight and thickness in school instal- 
lations. All plumbing for school toilets should be exposed, easily 
inspected, and readily accessible for rapid repair. 

Inside toilet construction. — ^The requirements for the construction 
of inside toilets are well understood. In general, for purposes of 
sanitation, urinals and toilet-room floors should be composed of non- 
absorbent, noncorrosive materials. Urinals are usually constructed 
of slate. The toilet-room floors should never be of wood or con- 

1 It mny be safely stated that no toilet unconnected with a sewer system should ]be 
located inside the school building. 



PRIVIES AND SOIL POLLUTION. 15 

Crete, because the former is more or less absorbent and the latter 
rapidly deteriorates under action of the acid contained in urine. 

A word, however, may be said of the manner of flushing toilets. 
The type which flushes automatically when the weight of the body 
is removed from the seat is desirable for very young children and in 
schools where but slight supervision of the toilet room is main- 
tained. Under other conditions the type which necessitates the pull- 
ing of a chain or other device is preferable, because the habitual 
performance of this act is a part of the child's education in sani- 
tation. 

OUTSIDE TOILETS OR PRIVIES. 

In the majority of rural schools reliance is placed on outside privies 
for the safe disposal of excreta. Such privies should be of a sani- 
tary type and screened from view for the sake of privacy. They 
should be ventilated to remove offensive odors, located sufficiently 
far from the school building to avoid a nuisance and from the water 
supply to minimize the danger of contamination through accidental 
soil pollution and improper upkeep. Privies should be at least two 
in number at each school, one for boys and one for girls, and should 
be located on a lower level than the water supply. 

Classification of privies. — Privies are classified according to the 
completeness with which the spread of infection by one or the other 
methods is excluded, namely, by man and animals, insects, and 
water. The virtual exclusion of any one of them is rated at 25 per 
cent, and of all three at 75 per cent. 

A total absence of the privy or other installation for the disposal 
of excrement is rated at zero. 

A surface privy open at the back decreases the chances for the 
spread of infection by the feet of man, and is rated at 10 per cent. 
A surface privy closed at the back largely eliminates the spread of 
infections by means of chickens, dogs, hogs, and man, but not rats, 
and is, therefore, rated at 25 per cent. 

The privy with a water-tight receptacle eliminates the spread of 
infection by seepage and by birds and mammals, and is rated at 
50 per cent. 

A Avater-tight receptacle privy closed in the back and thoroughly 
fly proof is rated at 75 per cent. 

The sanitary value of the " pit " privy varies with the soil forma- 
tion, the contour of the school ground, the height of the ground 
water level, vegetation, climate, and construction. A privy of this 
type may rank as low as 10 per cent and lower, or as high as 75 per 
cent when fly proof, closed in the back, and in an impervious soil.'^ 

1 A leaflet prepared by Prof. C. W. Stiles, of the U. S. Public Health Service, outlining 
the above classifications of privies, was distributed to the school teachers throughout the 
county, 



16 



BUKAL SCHOOL SANITATION. 



According to the classification outlined above, no privy in the 
county attained a rating higher than 50 per cent. These figures, 
however, do not accurately represent the efficiency of all the privies 
so rated, because the nature of the soil and the manner of obtaining 
water for use in the schools of this county afford greater protection 
from contamination than would be the case in communities not so 
advantageously situated. 

Sanitary primes.'^ — Two types of sanitary privies are now recog- 
nized, namely, removable-receptacle and stationary-receptacle privies. 
The essential part of a removable-receptacle privy is a water-tight 
receptacle, screened against flies. An arrangement of this sort can 
be adapted to any substantial existing privy house after minor 
and inexpensive alterations. Experience has shown that strong 







C-HVIILOt^ 



Fig. 1. — A stationary-receptacle sanitary privy witli a cement vault arranged for 

convenient cleaning. 

(From Public Health Bulletin 68.) 

cylindrical galvanized iron tubs or cans are most suitable for this 
purpose. Wooden receptacles soon warp, leak, and are entirely ob- 
jectionable. The adoption of this type of privy necessitates careful 
attention to ventilation measures to avoid odors. These measures 
may be supplemented by the use of drying powders, such as lime, 
earth, or ashes, or by the use of disinfecting solutions. 

The principal objection to this type of privy for school purposes 
is due to the necessity of emptying these receptacles at more or less 
frequent intervals and of disposing of the contents safely, a task not 
likely to be regularly performed. 

The most suitable manner of disposing of the contents, where 
privies of this type are in use, is by burial, which should be in the 
upper layers of the soil, at a depth not greater t han 2 feet, in order 

1 Public Health Bulletin No. 68, Washington, D. C, 



PRIVIES AND SOIL POLLUTION. 



17 



to take advantage of the natural purifying agencies, animal and 
vegetable, contained in the soil. The contents of privy receptacles 
should be buried not nearer than 100 feet to any water supply, in a 
place which is not likely to be disturbed by animals and which 
drains in the opposite direction. 

The excreta may be disinfected before burial by adding a freshly- 
made solution composed of 1 pound of chloride of lime to 8 gallons 
of water. 

A stationary-receptacle privy is far more suitable for rural schools 
than the removable type. In this type of privy advantage is taken 
of a phenomenon observed in ordinary cesspools — that is, that their 
contents liquefy, and solid matter is found only near the bottom. 
This is due to the action of certain living bacteria, which under 
favorable conditions exert a liquefying action on the solid organic 




Fig. 2. — An L. R. S. privj' M'ith tanks made of concrete and with direct distribution of 

effluent into top soil. 

(From Public Health Bulletin 68.) 

matter contained in human excrement. Privies of this type are 
easily maintained, are sanitary, and usually free from marked odors. 

In figures 1 and 2 are shown types recommended by the United 
States Public Health Service. The former represents a sanitary 
privy with a cement vault arranged for convenient cleaning, which 
is suitable for small schools ; the latter comprises two tanks made of 
cement with direct distribution of the effluent into the top soil. A 
privy of this type may be constructed on a sloping surface in such 
manner that the effluent pipe discharges into a suitable receptacle 
where it can be sterilized by heating, or by the use of disinfectants. 

As the living agents which bring about liquefaction lose their 
activity somewhat in cold weather and are killed by disinfectants, 
the concrete vault should be sufficiently deep to be protected from 

38062°— 16 2 



18 BUKAL SCHOOL SANITATION. 

freezing, and the use of disinfectants is inadmissible. Privies of 
this type, in fact all school privies, should be supplied with toilet 
paper, because it breaks up quite promptly. The use of heavy paper, 
cobs, and pieces of fabrics should be avoided. 

Privies were inspected at 73 schools. Of these the type was open- 
in-the-back at 9 schools, receptacle in 3, "pit" in 54, and cesspool 
and brick or cement vault in 8. There were 181 seats for boys and 
190 seats for girls. 

In figure 3 is shown an unsatisfactory girls' privy, found at one 
of the schools. Figure 4 represents a privy which is closed at the 
back, ventilated, and screened for privacy. 

The receptacle used in the three receptacle privies found during 
this survey was made of heavy planking. These receptacles, how- 
ever, were leaky, full to overflowing with excrement, and apparently 
had not been emptied since their installation. 

The majority of the privies inspected during this survey were 
of the pit type, which may be considered safe under certain rigid con- 
ditions of soil and climate, ground water level and proximity to 
water supplies. The use of driven wells at most of the Porter County 
schools, in connection with the glacial drift soil found over land of 
this kind, offers reasonable protection to the water supply from a 
privy located more than 100 feet distant, a protection not to be re- 
lied on in limestone districts and in marshy regions with a high 
ground water level. 

Distance of privy from water supply and from school huildings. — 
The privies of a number of schools were located at a distance con- 
siderably over 100 feet from the water supply, the average for the 
county being 90.7 feet. The distance, however, from the privy to 
the well varied in different townships. 

The average distance from the privy to the school building like- 
wise varied in different townships, being 48.3 feet for all schools. 

State of repair and maintenance of privies. — Privies were found in 
good repair in 18 schools, in fair repair in 27, and in poor repair in 23. 
In addition, privies for girls were found in good repair in 1 instance 
and in fair repair in 3 other instances, while the corresponding 
privies for boys were in poor repair at all 4 of these schools. 

The cleanliness of privies, however, was found to be good in 7 
schools only, fair in 22, and poor in 39. In other words, the up- 
keep and sanitary policing of the majority of the school privies in 
use in the countj^ were bad. The privies for girls were found in 
much better condition than those used by boys. An exception to 
this general rule is shown in figure 3. 

The question of soil pollution has received detailed consideration 
because of its important bearing on the problems of rural sanitation. 



PRIVIES AND SOIL POLLUTION. 



19 




Fig. 3. — Girls' privy at Porter County School. 



20 



RURAL SCHOOL SANITATION. 



It is felt that insistence upon the construction of sanitary privies for 
use at rural schools with due attention to their upkeep will probably 
do more to impress the rising generation with the importance of 
observing hygienic laws than any other measure which may be 
employed for that purpose in connection with school life. 




Pig. 4. — Type of " pit privy," T'entllated and screened for privacy. 
(U. S. Public Health Service.) 



SCHOOL BUILDINGS. 

NUMBER AND CONSTRUCTION. 



At the time of this survey, May, 1915, 77 rural schools were in 
actual operation in Porter County. Two of these were not in- 
spected, namely, the parochial building at Chesterton and the Hayes 



School buildings. gl 

School, Center Township. Of 75 schools, 44.5 per cent were frame 
structures, 2.6 per cent cement, and 52.9 per cent brick. 

Number of stories. — Eighty-nine and three-tenths per cent of all 
the rural school buildings inspected in the county were one-story 
structures. Of these one-story buildings, 34, or 50.7 per cent, were 
frame, and 33 were brick. None of the school buildings of the 
county consisted of more than two stories with a basement and all 
of these, eight in number, were of brick. 

In all, there were 114 classrooms, of which number 5 were either 
not in use or used for recitation purposes only. Of the remaining 
109 classrooms, 31 per cent were in one-story frame buildings, 27^ 
per cent in brick or cement structures, and the remainder, 41.5 per 
cent, were in two-story brick schools. It will be observed that the 
greatest number of classrooms in any one school was 9. In two 
other schools, however, the number of classrooms was 8 and 6, 
respectively. 

Basements. — The height of basement ceilings and the distance of 
the floor level below ground are largely influenced by the use for 
which the rooms are intended. When used for play purposes, or 
manual training and domestic science classes, the ceiling should be 
high, 12 or more feet, to make due allowance for ventilating ducts 
and other necessary piping. It is desirable in all cases for base- 
ments to receive daylight illumination. The top of the foundation, 
therefore, should be well above the ground level — from 3 to 5 feet, 
according to whether or not manual training and domestic science 
classrooms are to be located in the basement. 

A record was kept of the illumination of all basements inspected 
during this survey. These were classified as good in 12 schools, 
fair in 6, and poor in 5. The term "good" in this classification is 
relative, because in no case classified was the basement used for class- 
room purposes, which would require a better natural illumination 
than was found in any basement inspected during this survey. 

All school basements should be waterproof. Failure in this re- 
spect results in dampness. The basements were practically water- 
proof in 16 schools and without any attempts at waterproofing in 7 
others. This latter condition was due largely to the material used 
in floor construction. In 16 instances the basement floors were of 
cement, brick in 3, and earth in 4. 

Toilets were located in the basements in but three schools. The 
disadvantages of this system have been discussed elsewhere in this 
report. (See p. 14.) 

The ventilation of the basements was accomplished by windows 
in 21 schools, and in two others they were connected with the general 
ventilation system. At all schools with artificial ventilation installa- 
tions, however, insufficient precautions were taken to exclude cellar 



22 EUEAL SCHOOL SANITATION. 

air from the fresh-air intakes, a matter discussed more fully in the 
section of this report dealing with ventilation. (See p. 59.) Finally, 
seven basements were found in a dirty condition that should not be 
tolerated because of its bad example in sanitation. 

Orientation of school huildings. — The direction in which the 
school building faces influences largely the arranging and distribut- 
ing of classrooms so that a maximum illumination efficiency may be 
secured with the greatest comfort to the eye. There is also the ne- 
cessity of providing for the admission of sunlight to each classroom 
during some hour of the day because of its germicidal properties. 
Classrooms, therefore, which have north, northwest, west, southwest, 
and south exposures receive the least sunlight, in the order mentioned. 

The orientation of the school building a few points off the com- 
pass permits the easiest arrangement of classrooms for the purposes 
mentioned. The roads of Porter County, however, either follow or 
parallel section lines : that is, they are north and south, and east and 
west. For this reason the school buildings set square with the com- 
pass, otherwise their relation to the school plot would be an irregular 
one. The majority of the Porter County schools are one-room struc- 
tures which readily lend themselves to classroom orientation best 
adapted to the purposes of daylight illumination, irrespective of the 
direction in which the building faces. 

The orientation of the school buildings of the county was as 
follows: Ten faced north, 23 east, 25 south, and 17 west. Of 109 
classrooms investigated from the standpoint of orientation, 35, or 
32.5 per cent, faced north; 21, or 19.2 per cent, east; 23, or 21.1 per 
cent, south ; and 30, or 27.2 per cent, west. 

Date of construction. — The greatest number of sanitary defects 
met with during this survey were in connection with very old build- 
ings, erected long before the development of school hygiene as a 
factor in the education, sanitation, and economics of communities. 
In a measure this is fortunate, because it encourages school consoli- 
dation by lessening the objection to the abandonment of buildings 
which have almost passed the limit of usefulness. 

Ten of the rural school buildings were less than 5 years old, 6 be- 
tween 5 and lO years, 16 between 10 and 20 years, and 43, or 57 per 
cent of the total number, were more than 20 years old. 

Attempts at renovation had been made in a few instances. In 
general, the expense of remodelling a number of these old build- 
ings to meet the requirements of school hygiene would be nearly as 
great as new construction. This is another argument in favor of 
consolidation of rural schools as an economic measure, as is the fact 
that the attendance at some of these schools was very small. In one 
school there were only 4 pupils present and but 6 in another. Never- 



SCHOOL BUILDINGS. 23 

theless, the operating expenses of these schools are as great as that in 
schools with larger attendance and more modern equipment. 

Foundations. — It is not unusual to find one-room school buildings 
in remote districts on inadequate foundations. The most serious 
fault in this respect is the use of pillars, an arrangement that gives 
free sweep to the winds beneath the buildings, causing cold floors, 
cold feet, and adding materially to the cost of heating. 

The foundation of all small school buildings should be closed in 
and provided with screened ventilation openings. The Indiana law 
requires that the top of these foundations shall be at least 3 feet 
above the ground level to provide against damp and rotting floors. 

The foundations of all the rural schools of the county were of 
the closed-in type. In one or two instances these were in poor re- 
pair. 

Roofing. — The material used for the roofing of school buildings is 
important from the standpoint of fire protection and frequency of 
renewal. Slate roofing is probably the most desirable in this re- 
spect. The roofs of nine schools of the county were of this type. In 
spite of its desirable qualities, the use of slate for roofing is a doubt- 
ful economy in small one-story school buildings, where it may be 
easily broken by children at play. The repair of a slate roof neces- 
sitates the employment of one skilled in this work and not usually 
available in rural communities. 

The greatest number of rural schools, 64 or 85 per cent, had 
shingle roofs. Two had tin roofs. 

STATE OF REPAIR. 

The upkeep of school buildings is as necessary an educational and 
sanitary measure as the establishment of hygienic structures. The 
cost of maintenance and repair constitutes not an inconsiderable part 
of the operating of school plants, but neglect of this duty is obviously 
a false economy. 

The state of repair of 43 buildings inspected was good, of 24 fair, 
and of 8 poor. This classification takes into consideration the 
grossest conditions of structure only, without reference to the number 
of schools in need of interior redecorations. 

FIRE PROTECTION. 

Brief consideration only is given in this report to measures of fire 
protection. The requirements for this purpose are incorporated in 
the building codes of the several States. 

As a life-saving measure protection against fire in small one-story 
rural schools is of secondary importance to insurance against prop- 
erty loss. It is inconceivable that a fire should gain sufficient head- 



24 RURAL SCHOOL SANITATION". 

way in a building of this type effectually to close the avenues of 
exit before the building could be emptied. 

Nevertheless, the natural increase in population and the modern 
tendency to consolidate rural schools call for larger buildings of 
more than one story, a type of construction demanding greater safe- 
guards against fire for the protection of life. Briefly, the extent of 
fire protection afforded in any one building is measured by the ma- 
terials used in its construction, height of the building, presence or 
absence of fire escapes, location and arrangements of exits, stair- 
ways, and classrooms, heating system used and isolation of the heat- 
ing apparatus in fireproof structures, location of the heating appa- 
ratus with respect to entrances, installation of fire plugs and hose, 
provision of hand grenades and patent fire extinguishers, and finally, 
institution of fire drills. 

It is exceedingly difficult to make a school building completely fire- 
proof. The extent to which such material is employed in school- 
house construction will depend largely on the accessibility of dif- 
ferent localities to the sources of supply. 

The higher the building the greater the danger to life in case of 
fire. The Indiana law limits the height of buildings used for school 
purposes to two stories and a basement. All the two-story school 
buildings inspected during this survey were of brick construction. 
The greatest number of highly inflammable buildings were one-story 
frame structures, which constituted 44.5 per cent of all the rural 
school buildings in the count3^ No fire-fighting apparatus was ob- 
served in any rural school building in the county, a condition which 
should be remedied. 

Five buildings were provided with fire escapes of the open-ladder 
type, which in one case consisted of a simple iron ladder without a 
platform leading from the classroom window to the ground. The 
open type of fire escape doubtless answers the requirements of rural 
communities where the school attendance is relatively small and the 
children accustomed to climbing. In congested districts, however, 
the inclosed type of fire escape is desirable. 

Buildings with central heating plants should have the heating ap- 
paratus placed in a fireproof inclosure. The new school at Hebron 
is equipped in this manner. The heating plant of the Crisman 
school, consisting of furnaces located in the cellar, is a distinct 
menace by reason of the close proximity of the furnace top to the 
low wooden ceiling. The heating apparatus should be located as far 
as possible from exits to avoid cutting off avenues of egress in the 
case of fire originating at this source. 

The value of fire drills, as a life-saving measure, has been demon- 
strated time and time again in the case of fire. This practice enables 
the building to be emptied not only in the shortest possible time, but 



SCHOOL BUILDINGS. 26 

in an orderly manner necessary to avoid panics and injury. Aside 
from these considerations fire drills are of distinct value for teach- 
ing self-reliance in time of stress. 

Lastly, the arrangement of building exits which open out and are 
provided with fire bolts is a further precaution for the protection 
of life in case of fire. Entrance doors opening in the wrong direc- 
tion were observed in 53 per cent of the schools of the county, 38 
opening out, 40 opening in. 

Outside doors opened into halls in 29, or 34.7 per cent, of the 
schools ; into vestibules in 37, or 49.3 per cent ; and directly into the 
classroom in 12, or 16 per cent. 

WATER SUPPLY AND LAVATORY FACILITIES. 

Due attention must be paid to the water supply of schools to 
secure a supply which is free not only from contamination with dis- 
ease agents, but from other objectionable features that might cause 
children to refrain from its use in desirable quantities. 

The detection of the presence of harmful agents in drinking water 
requires special facilities which are lacking in nearly all rural com- 
munities. Therefore, especial attention must be paid to the installa- 
tion of sanitary privies to protect water supplies. 

Sources of water swpply. — Rural schools secure drinking water 
largely from shallow wells, which frequently become contaminated. 
The water obtained in this manner is that part of the rainfall which 
sinks into the ground until an impervious layer of clay or rock is 
reached and which finds an outlet at lower levels. A shallow well 
taps this flow of ground water and drains an area in the form of 
an inverted cone, with the point at its bottom. The diameter of the 
area thus drained is variously estimated by authorities to be 20 or 
more times the depth of the well, depending on the nature of the 
soil. The soil of Porter County, however, is a natural filter, so 
that the protection afforded the water from natural means is far 
greater than that afforded by the sanitary conveniences most fre- 
quently found at the schools. 

Unless due precautions are taken, the shallow well is a constant 
source of danger. It should be protected from surface drainage to 
a depth of several feet and located as far as practicable from sources 
of contamination. 

Three of the rural schools of Porter County are connected Avith 
the town water systems, namely, Flint Lake, Chesterton, and Porter 
schools. The new school at Hebron has been fitted for connection 
with the town supply, which, however, had not been introduced at 
the time of this inspection. Two other schools are supplied by wells 
from 125 to 130 feet in depth, respectively. 



26 RURAL SCHOOL SANITATION. 

Driven wells. — The water used in nearly 75 per cent of the rural 
schools of the county was obtained from shallow driven wells.^ 
Thirteen, or 17.3 per cent of all the schools of the county, were with- 
out wells. In these cases all water used for school purposes was 
brought from neighboring farmhouses, in some instances one-quarter 
of a mile or more distant. This practice, is bad because of the possi- 
bility of obtaining water from infected wells. 

The wells of four schools were not in use, and at nine other schools 
the pumps were out of order. This increased the number of schools 
taking water from neighboring farmhouses to 26, or nearly 35 per 
cent of all the rural schools in the county. 

The distance at which the well is located from the privy is a 
factor in the freedom from contamination of the water supply. The 
average distance separating the well from the privy for the county 
was 90.7 feet, as stated elsewhere (p. 18). 

Wells should not be located near the entrance to school buildings. 
In places where due care is not given to the drainage of waste water, 
the space surrounding the well becomes an unsightly mudhole, from 
which dirt may be carried directly to the schoolroom. Furthermore, 
the floor sweepings added to this mass increase the liability of such 
wells to contamination with infectious material. 

At four schools in the county the well was located within 6 feet 
of the building and under the basement in two other instances,- the 
average distance for all schools of the county being 32 feet. The 
objection to locating the well under the basement is largely due to 
the difficulties of repair and to the dampness by water wasted on the 
basement floor. 

Protection from surface drainage. — The protection of the wells of 
the county from surface drainage seems to have been influenced 
largely by the desire to avoid a muddy approach rather than from 
the viewpoint of sanitation. This is indicated by the use of boards 
for this purpose at a large number of the schools. 

In figures 5 and 6 are shown types of pump installations and the 
extent of protection from surface and waste water drainage. In 
but few instances has this been done in the proper manner. 

In a number of instances the upper part of the well consisted of a 
walled-in pit several feet in diameter, ranging from 6 to 8 feet in 
depth, through the bottom of which the well had been driven. In 

some cases the bottom of this pit contained a layer of charcoal for 

, ^^ _______ 

1 Driven wells are those constructed by driving an iron pipe into the soil and com- 
pleted by fitting the pump to its top after being driven to such a depth as to obtain a 
sufficient flow of water. 

- Two schools other than the ones mentioned, namely, Kouts and Porter schools, had 
wells located under the basement. These wells, however, were no longer used to supply 
drinking water. 



WATER SUPPLY AND LAVATORY FACILITIES. 



27 



the filtration of waste waters. The boards covering these pits in 
most instances had been disarranged, and in consequence they served 
as a catchall for very offensive substances. 




Fig. 5. — Shallow-driven well with trough for drainage of waste water. 

Water containers. — Sanitary drinking fountains of the various 
stationary types were found in seven schools. Of these, two were out 
of order and one was not in use. 



n 



RURAL SCHOOL SAKlTAMOif. 



In all other cases the children drink at the well, a common prac- 
tice also in a number of schools provided with water buckets and 




Fig. 6.— School well surrounded by shallow pit and board protection from surface drainage. 

drinking fountains. " Bubbling-fountain attachments to the town 
water supply were observed in Chesterton and Porter schools. The 
new school at Hebron is now equipped in like manner. 



WATER SUPPLY AND LAVATORY FACILITIES. 29 

Facilities for washing hands. — Children should be taught the value 
of personal hygiene in the maintenance of health. This is especially 
true of the necessity of cleaning the hands frequently. They become 
soiled during play, while attending to the calls of nature, through 
handling soiled objects, and are carried immediately to the face, 
perhaps introducing infectious material into the mouth, nose, or eyes. 
In the same manner books, pencils, and other objects may become 
infected. 

Sinks were provided in three schools, and were a part of the water 
and sewer systems. At 56 schools, practically 75 per cent of the total, 
common washbasins were provided. At three of these schools the 
basins were frankly, and in a number of other instances obviously, 
not in use. Paper towels were provided at eight schools, notably at 
all six of the schools in Pleasant Township. Individual or " family " 
towels provided by the parents were reported in use at three schools, 
common towels at 41. 

Use of corn/mon drinking cup. — The use of the common drinking 
cup in public places is not prohibited by law in the State of Indiana, 
notwithstanding they are dangerous to health. Prof. Davison,^ of 
Lafayette College, found human cells scraped from the lips of per- 
sons while drinking so numerous on the upper third of a glass in 
use only nine days that the head of a pin could not be placed any- 
where thereon without touching one or more of these small pieces 
of human tissue. 

More to the point, however, is that he found germ cells left by the 
saliva deposited while drinking in such a quantity that not less than 
100,000 bacteria were present on every square inch of this glass. He 
found by special methods that a number of these organisms were of 
the kind which produce disease. 

During this survey the common cup only was in use in 14.3 per 
cent of the rural schools of the county, individual cups only in 42.5 
per cent, and individual cups by some of the pupils and the common 
cup by the others in 40 per cent.^ In most coses, however, the so- 
called individual cup was a " family " cup used by the members of 
the same family. The practice of lending the individual cups to 
others was found on inquiry to be quite common, so that these were 
essentially common drinking cups. 

The use of individual cups, with a suitable place for keeping them 
and due explanation of their need, should be imperative in all schools 
as an object lesson in personal hygiene. 

1 Prof. Davison : Technical World Magazine, August, 1908. 

2 Water buckets in 24 scliools, common cups in 31, individual cups in 52. 



30 EUEAL SCHOOL SANITATION. 

CLASSROOM EQUIPMENT. 

The essential features of the classroom equipment from a hygienic 
standpoint are briefly : The number, type, and arrangement of desks ; 
the location of blackboards; their composition, width, and height 
above the floor level ; and provisions for the collection of dust and the 
use of window shades, their color and adjustment. Preliminary to a 
discussion of these features of classroom equipment brief mention 
may be made of classroom walls and floors. 

CLASSROOIM WALLS. 

The color and finish of classroom walls are of prime importance 
from the standpoint of illumination. In general, classroom walls 
should be of hard plaster and tinted some pleasing color of high 
reflection coeflicient, using oil paint. The finish should be without 
gloss to avoid glare. The use of wainscoting is intended primarily 
for the protection of the walls from injury. For this purpose some 
form of tiling may be used in halls and corridors. Classroom walls, 
however, are not subjected to the same danger of mutilation; and 
the wainscoting is used largely to tone down the light reflected 
by the lower portion of the walls. This can be accomplished readily 
by painting a strip of the plastering to the necessary height, about 4 
feet above the floor level. Its color should have a reflection co- 
efficient not higher than 30. 

The use of wooden wainscoting is undesirable in classrooms be- 
cause it adds to the inflammable material. Painted burlap for this 
purpose is also undesirable. This substance presents a roughened 
surface for the collection of dust and does not readily lend itself to 
washing. 

All corners, as well as the junction of the walls with the ceiling 
and floor, should be rounded. This arrangement is intended to avoid 
the collection of dust and to permit washing the walls effectively. 

FLOORS. 

The use of wood in the construction of classroom floors is advo- 
cated from the standpoint of comfort. The flooring material in all 
cases should be narrow, not over 2 inches wide, and laid as tightly as 
possible, using concealed nails. 

To reduce dust the floor may be oiled, and where vacuum cleaners 
are not available a sweeping compound may be employed. The In- 
diana law requires the oiling of classroom floors twice during the 
school year. Oiling of floors was observed in nearly all the schools 
inspected to the extent of at least once annually, generally at the 
beginning of the school year. Further consideration of dust and its 
effects will be given under another caption (p. 59). 



CLASSROOM EQUIPMENT. 31 

SCHOOL DESKS. 

It is not possible to dissociate the consideration of school desks 
from posture in school children and the effect of faulty posture on 
health. The deformity most usually associated with faulty posture 
is some form of functional spinal curvature. For this reason pos- 
ture and postural defects will be considered in another section of this 
report which deals with defects among school children (p. 88). 

Irrespective of the cause of postural defects, many of them may 
be overcome by appropriate measures during the period of school 
life. Of these measures may be mentioned the adjustment of the 
desk to the child. Probably upon no single physical feature con- 
nected with schools have such definite conclusions been reached as 
upon the relation of school desks to children. It is now quite gen- 
erally agreed that the height of the desk should be so adjusted that 
the arms of the seated child will rest naturally on the desk in an easy 
position, with the elbows at the side. 

The size of the desk top should vary according to the grade. That 
advocated in the Boston code is as follows: Grades I to III, 12 by 
18 inches; grades IV to YI, 15 by 21 inches, and for grades VII to 
VIII, 16 by 23 inches. The slope of the desk should xnry from 15° 
for writing, to 30° or 45° for reading. These regulations are in- 
tended to cause the child to maintain an upright position and to pre- 
vent his bending the head unnaturally while performing school 
tasks. 

The desk seat should be adjusted to allow the feet to rest squarely 
on the floor when the legs are flexed at right angles. It may be flat 
or curved to fit the buttocks. The front edge should be rounded. 
The depth of the seat from front to back should be two-thirds the 
length of the thigh. 

The relation of the seat to the desk has been described as minus, 
plus, and zero, depending on whether the front edge is in front, to 
the rear, or on a line with a perpendicular from the edge of the desk 
to the floor. This measurement should never exceed 1 inch in any di- 
rection. The plus arrangement has been found most suitable for 
general school purposes. 

The distance from the seat to the top of the desk should equal 
about one-sixth of the height of the body. The back should be 
placed at right angles to the seat and extend to the shoulder blades, 
curved concavely from side to side and convexly from above down- 
ward, giving support to the lumbar spine. These desk requirements 
cause the child to assume an upright posture, prevent sprawling and 
the assumption of slouchy postures, and place the work at the 
proper angle and distance for visual comfort. These requirements, 
however, cause considerable restraint to the natural activities of 
young children and therefore necessitate frequent rest periods, espe- 
cially in the lower grades. 



32 RUEAL SCHOOL SANITATION. 

Adjustable desks. — ^The use of some form of adjustable desk is 
necessary to fulfill all the requirements of an ideal school seat. The 
frequency of adjustment depends upon the sex and age of the child. 
Adjustments should be made, however, in all cases at the beginning 
of the school year. As a rule, girls grow more rapidly in height 
between the ages of 12 and 14 and boys between the ages of 14 and 
16. The girls in Porter County schools, however, attain their most 
rapid growth from 12 to 14 and the boys from 13 to 15 years. Special 
care should be given to the more frequent adjustment of desks to 
children at these periods of rapid growth than at other age periods. 

Adjustable desks are in use in only 9.15 per cent of the classrooms 
of the county. Most of the classrooms with nonadjustable desks, 
however, were supplied with desks of various sizes for children of 
different heights. 

NuTiiber and arrangement of desks. — The average number of desks 
per classroom for the county was 33.7, influenced by the necessity of 
seating an undesirable number of children in the one-room schools 
of the county. The number of seats provided, however, was in excess 
of the children present. Ten classrooms had adjustable seats; 95 
nonadjustable. 

Desks should be arranged with a view to obtaining the greatest 
visual comfort and separation of the pupils in the interest of 
health. The desks should be arranged in parallel rows, with win- 
dows to the left and rear. To avoid shadows the smallest seats 
should be nearest the windows and successive rows in regular grada- 
tion. Desk rows should not be nearer the wall than 24 inches. Aisles 
separating desk rows should be 18 to 20 inches wide, according to 
the grade. 

The average width of aisles separating desks from classroom walls 
in the county was as follows : Right aisle, 39.7 inches ; left aisle, 29.7 
inches; front, 7.8 feet; rear, 3.3 feet; and the average distance be- 
tween desk rows was 21.4 inches. In a number of schools, however, 
the desks were placed as closely as possible to the windows and walls, 
a very undesirable situation from the standpoint of illumination, 
and also undesirable because this arrangement interferes materially 
with the cleaning of floors. Furthermore, window ventilation can 
not be practiced without subjecting the children occupying these 
seats to objectionable drafts. 

WINDOW SHADES. 

The requirements to be fulfilled by window shades are that they be 
translucent, be adjustable from either top or bottom, and be kept in 
good repair. A window shade which transmits colored light rays is 
undesirable. The translucent shade should be supplemented by an 
opaque one between it and the light source to shut out direct sunlight. 



CLASSEOOM EQUIPMENT. 83 

Window shades adjustable from top and bottom were found in 
51.5 per cent of the classrooms of the county.^ There were no 
shades whatever in three schools, and the shades were in poor condi- 
tion in at least nine other classrooms. The latter statement is con- 
servative, because a number of window shades in other classrooms 
were badly faded and require replacement at an early date. All of 
the window shades in the county were semiopaque, the predominant 
colors being some shade of green or yellow. 

In a large number of classrooms inspected during this survey the 
lower sashes of windows were more or less obscured by muslin win- 
dow curtains. No doubt this arrangement imparts a more homelike 
aspect to the classroom; but the practice is objectionable, because 
these curtains not only reduce the amount of daylight admitted to 
the classroom but do so increasingly by reason of the accumulation 
on them of dust and dirt. 

BLACKBOARDS. 

The use of blackboards is so necessary to classroom instruction 
that careful attention should be given to their construction, width, 
height, distance from the floor level, and location with respect to 
windows. 

The use of wood for this purpose is no longer tolerated in well- 
regulated schools. The surface of such boards soon acquires a polish 
which causes glare that markedly interferes with vision. Composi- 
tion blackboards are now on the market which give good service for 
a time. A number of these, however, have no very great lasting 
qualities and soon acquire an irregular surface which interferes with 
both writing and vision. Liquid slate applied directly to the wall or 
to a concrete surface requires frequent renewal, pending which un- 
satisfactory service is given. 

The cheapest blackboard material in the end is slate. To meet the 
requirements of an ideal blackboard, however, the slate must pre- 
sent a dull black surface. 

Slate was used for this purpose in 89, or 85.5 per cent, of the 
classrooms of the county. Composition blackboards were used in 7 
classrooms, wood in 1, and a painted wall strip in 8 others. 

'Blackboard dimensions. — The statement that a classroom can not 
have too much blackboard space needs qualification, because it was 
made evidently without due regard to the requirements of classroom 
illumination. The light absorption by black surfaces is so great 
that an undue proportion of blackboard space reduces the amount 
of light diffusion in the room. Where the demands for large black- 

* window shades in 54 classrooms were adjusted from top, in 46 from top and bottom, 
In 67 they were green and in 30 tan. 

38062°— 16 ^3 



34 EUEAL SCHOOL SANITATION". 

board surfaces are imperative, however, the blackboards might be 
fitted with curtains of light color adjusted to rollers, which could be 
drawn when the boards are not in use. 

The standard width up and down of blackboard surfaces is 4 feet, 
the average for the county being 41.6 inches. In practice it has not 
been found necessary for the top of the blackboard to reach a higher 
level than 6^ feet above the floor. 

Blackboards in classrooms intended for the primary grades should 
be placed at a lower level than in the case of those for the higher 
classes. When placed too high the arms are raised to a height while 
using them which soon induces fatigue. An acceptable measurement 
from the floor level now advocated is 26 inches for the primary 
grades and 30 inches in the higher grades. The average distance 
from the floor for all grades in the classrooms of the county was 33.5 
inches, ranging from 24 to 40 inches. 

Location of hlachboards. — Blackboards should never be placed 
between windows nor in obscure parts of the classroom. In the for- 
mer position the contrast between this dark surface and the window 
brightness causes glare which is so great as to render such boards 
practically useless for classroom instruction. In the latter case the 
obscurity of that portion of the classroom is intensified by the light 
absorption by these black surfaces. The best location for the black- 
board is the front wall of the classroom. This space may be sup- 
plemented by utilizing the right-hand wall. In both of these lo- 
cations blackboards receive good light and are visible without dis- 
comfort to the entire class. Blackboards should never be placed on 
walls having windows or on the rear wall of the classroom under 
any circumstances. In classrooms lighted from one side only, the 
location of blackboards on the opposite wall causes great light ab- 
sorption, which may be avoided by the use of curtains in the manner 
already described. In 36 per cent of the classrooms of the county 
the blackboards were located with windows to the left and opposite, 
on either side in 33 per cent, on either side and opposite in 21 per 
cent, and to the right and opposite in 7 per cent. ^ 

ChSh troughs. — Classrooms may be protected to a large extent 
from blackboard dust by the use of shallow troughs, from 3 to 4 
inches wide, which are placed at the bottom of the blackboards and 
covered by a detachable wire screen of coarse mesh. This latter 
arrangement protects the fingers, crayons, and erasers from the ac- 
cumulations of powdered chalk. Dust from these sources is irritating 
to the respiratory mucous membrane. These receptacles, therefore, 
should receive careful attention and be emptied daily after school 
hours. Practically all of the classrooms of the county were equipped 

1 Windows to right in 7 rooms, to left in 36 ; blackboards between windows In 56, 
windows opposite in 70. 



CLASSROOM EQUIPMENT. 35 

with some arrangement for this purpose; but few of them were 
protected by wire screens. 

DAYLIGHT ILLUMINATION OF CLASSROOMS. 

Studies were made of the daylight illumination of 109 classrooms 
in 75 rural schools during the course of this survey. Faulty illumi- 
nation may cause lasting injury to the visual health; for instance, 
not only may it aggravate the condition of nearsightedness in young 
children, but it is also considered by many authorities a cause of this 
condition. 

Defective illumination of classrooms has an adverse influence 
also on the activity of the intellectual processes of children. The 
young child requires greater intensity of illumination than the adult 
to enable it to interpret the meaning of written or printed char- 
acters. One reason for this is physiological. Another is that these 
characters are familiar to an adult, and are, therefore, easily recog- 
nized and interpreted under conditions of poor illumination. Fur- 
thermore, the mind of the young child functionates largely in pro- 
portion to the volume of stimulation received through the eye. 
Whenever, by reason of faulty illumination, extra effort is required 
of the ocular muscles to accommodate for the recognition of written 
or printed characters, fatigue is soon produced, and the intellectual 
development of the child is hampered. 

Faulty illumination causes the assumption of injurious postures 
and the acquirement of a " postural habit " that may aid indirectly 
in the production of postural defects which may ultimately act in- 
juriously on the general health in later life. In fact, the faulty 
posture frequently assumed by the child under conditions of poor 
illumination has been assigned by a number of medical authorities as 
a causative factor in the production of nearsightedness. 

SECUEING AN ABUNDANCE OF ILLUMINATION. 

The whole subject of illumination is highly technical, aad the 
practical application of the principles involved, in so far as daylight 
illumination is concerned, is not easy, due to the absence of working 
standards occasioned by the numerous accommodation factors in- 
volved. In recent years, with increased knowledge of the funda- 
mental principles of illumination, the illuminating engineer and the 
architect have deduced certain requirements for the daylight illumi- 
nation of classrooms. The object of these requirements is to secure 
an abundance of light from the right direction, to insure a maximum 
diffusion with the avoidance of objectionable glare, and to make 
suitable provision for its regulation by increasing or diminishing the 
amount of light admitted as necessity may demand. 



36 



RURAL SCHOOL SANITATION. 



Window area. — In order that sufficient light may enter classrooms 
properly to illuminate all desks under all conditions, certain meas- 
ures of illumination have been adopted from time to time. Perhaps 
the most widely accepted of these, at least in this country, is the one 



Standard 



Porter County Schools 





U.5. Public Health Service 

Chart 1. — Standard ratio of glass area to floor space of schoolrooms and average ratio in 

Porter County. 

which requires the glass area of classroom windows to be not less 
than one- fourth the floor space of the classroom. In Porter County 
the average ratio of glass area to floor space was 15.5. 

In charts 1 and 2 are shown graphically the standard ratio of 
glass area to floor space, the average for all the rural schools of 



MAXIMUM 



MIWIMUM 





U.5. Public Health Service 

Chart 2. — Maximum and minimum ratios of glass area to floor space in classrooms of 

Porter County. 

Porter County, and likewise the county maximum and minimum. It 
will be seen at a glance that even the maximum architectural pro- 
vision for classroom illumination is considerably less than the gen- 
erally accepted standard. 



DAYLIGHT ILLUMINATION OF CLASSROOMS. 



37 



It must not be supposed that the desk iUumination of all the rural 
schools of Porter County is as deficient as indicated by the foregoing 
charts. Actual photometric observations made in a number of 
schools representing county types show that this is not the case. 
The apparent discrepancy is due to the relatively small number of 
desks, which may therefore be grouped near to windows and occupy 
a space commensurate with lighting efficiency. 

In chart 3 is given the desk illumination of the fifth grade in the 
Chesterton school, "Westchester Township. It will be observed that 
this classroom, with a window-glass area of 17 per cent, had a high 
desk illumination, nowhere less than 23.3 foot-candles. These ob- 
servations were made under favorable meteorological conditions. 

Illumination— CLAS5Rooti,CRADE"V^CHESTERTON High ScH00L.CnE5TERT0N.PoffTERCou»frY. Indiana. 



Teache 



1 



OttV 

□ □ n □ ED 

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- 39 ft 



Weather CONDITIONS-FAIR. KD: 10 A.M,Mav 5.1915. Window ilujmimation '385.4 FOOT candle &. 

M.%. Public HEAUN^EAvtcc 

Chart 3. 

The high illumination intensity, however, was due largely to win- 
dows on the left and rear of the seated pupils and to the location of 
the classroom on the second floor, which permitted an unobstructed 
sky surface. 

The high illumination intensity shown in this classroom calls for 
regulation by appropriate means. 

Chart 4 is particularly instructive because it shows the necessity 
of a different desk arrangement in closer proximity to windows and 
the serious consequences from the standpoint of illumination of 
classrooms of great depth in a direction opposite the light source. 
In cloudy weather it is necessary to supplement the illumination of 



38 



EUEAL SCHOOL SANITATION. 



this room by artificial means, an exigency which could be obviated 
in a measure by grouping the desks nearer the windows. 

The utilization of this standard, however, is conditioned by cer- 
tain more or less rigid restrictions. In the first place, it must not be 
forgotten that the illumination of a given desk in a classroom is 
inversely as the square of the distance from the source, which in 
this instance is the classroom window. The adoption of this stand- 
ard of illumination, therefore, fixes the width of classrooms within 
very definite limits, so that no desk should be removed further than 
20 feet from the source of light under average conditions of one- 
sided illumination. 



lLLOMrNATioiM-CLA5SRoOM, Grade Iff, Chesterton High School, Chesterton, Porter (Bounty, Indiana. 



yf 



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Weather CONDITIONS-FAIR, 2.Z0PM. May 3,1915 WiNbowiLuuMiNATiON 166.6 foot candles. 

us. Public Health 5eRvicc 
Chart 4. 

The amount of light entering classroom windows of a given area 
is modified by the angle of incidence, by the proximity and color of 
neighboring buildings, by the presence or absence of shade trees, by 
projecting eaves, by variation in the number of sunny days, by the 
distance of the upper edge of the window from the ceiling, and 
even by the thickness and quality of the glass used in windows. 

Nearness of neighboring buildings hardly enters the problem of 
rural school construction. Nearness of shade trees, however, may 
seriously interfere with the admission of daylight to classrooms. 

Visible sky vault. — In order that the pupil may receive the light 
necessary for the illumination of his desk, a measure has been sug- 
gested which demands that the child shall be able to see a part of 
the sky vault from his seat. It has been suggested that this sky 



DAYLIGHT ILLUMINATION OF CLASSROOMS. 39 

surface be measured by a reduced solid angle of not less than 50 
square degi'ees. This provision presupposes that the angle of inci- 
dence of luminous rays, that is, an angle formed by a plane from the 
upper surface of the desk cutting the upper edge of the window, and 
another plane from the same point cutting the lower edge of the 
visible sky surface, should be not less than 5°. Moreover, the angle 
of elevation of the luminous rays, that is, the angle included between 
the upper of these two planes and the horizontal, should not be less 
than 25°. These and similar measures of illumination, however, 
admit of wide variations, because they take into consideration direct 
light only, without reference to the important factor of reflected 
light from whatever source. 

Photometric standards. — The adoption of a standard of desk 
illumination based on actual photometric observations is the most 
rational of all requirements to secure the proper illumination of 
classrooms. The amount of light so measured should not be less than 
10 foot-candles at any desk under all conditions. The measure sug- 
gested is higher than that usually advocated. But it must be remem- 
bered that it is easier to regulate an excess of light than to provide 
for more after the school building has been constructed. 

One of the difficulties attending this standard, however, is the 
necessity of working out all architectural features affecting illumi- 
nation, because of the wide daily and seasonal variation of meteoro- 
logical conditions in different sections of the country. 

On the other hand, there are certain architectural features having 
a direct bearing on the amount of daylight entering the classroom 
which should not be omitted under any climatic conditions. Not only 
is it desirable to have a certain extent of sky surface visible from 
the desk, but the light proceeding from these sources should enter 
the classroom at as great an angle of inclination as possible. For this 
reason the upper edge of all windows should reach the ceiling so that 
the rays of light entering may approach more nearly the perpendi- 
cular and insure a maximum of diffusion with the elimination of 
objectionable glare. On an average the top of the windows were 25.6 
inches from the ceiling and the lower edge 35.2 inches from the 
floor. 

Less reliahle measures of illumination efficiency. — In remote dis- 
tricts and even in communities having model f acilitiesi for illumination, 
it is very desirable to provide teachers with some simple and prac- 
tical guide for determining the illumination efficiency in classrooms. 
Even where proper facilities have been provided, good illumination 
depends largely on the efficiency of the janitor's service and the per- 
sonal equation of individual teachers. For example, the absorption 
of light transmitted through ordinary window glass is about 10 per 
cent. This loss is greatly augmented where the cleaning of win- 



40 EUEAL SCHOOL SANITATION. 

dews has been neglected and dust and dirt allowed to accumulate 
on the window panes. Not infrequently, opaque window shades are 
drawn to exclude excessive illumination and left in this position 
when the necessity is past. Curtain fixtures readily get out of repair 
and remain so through neglect of the janitor or school authorities, 
and are thus a disturbing factor in the proper illumination of the 
classroom. 

Probably the most readily available measure suggested is the 
ability of the normal eye to read diamond type readily at a distance 
of 20 inches. A framed card bearing one or two paragraphs printed 
in diamond type may be utilized for this purpose. 

It has also been suggested that a row of square dots, 1.4 millimeters 
each way, separated by 1.4 millimeters, be added to the ordinary test 
card. Under usual conditions these dots are seen as a row of squares 
at a distance of 20 feet. If the light be poor, however, the dots be- 
come fused into a continuous line. 

These tests are purely relative and serve solely to call attention 
to possible deficiencies of illumination. The use of such tests by 
far-sighted persons or by persons more than 40 years of age would 
call for correction by glasses. 

POSITION OF ILLUMINATION SOURCE WITH RESPECT TO DESK 
ARRANGEMENT. 

The provision of an abundance of light is but one of the require- 
ments for satisfactory illumination. Daylight must be admitted 
from the proper direction also if the maximum effect with the least 
discomfort to the visual apparatus is to be secured. Classroom win- 
dows, therefore, must never be located in such a manner as to permit 
light to fall in the faces of the seated children, nor should they be 
opposite each other because of the cross lights and confusing shadows 
produced by this arrangement. 

Unilateral window arrangement to the left of the seated pupils is 
quite generally adopted in this country. There are two serious ob- 
jections to this practice. In the first place, frequently the shadow 
of a very stout child, seated between the window and the desk oc- 
cupied by a child who is much smaller physically, reduces the illumi- 
nation of the latter's desk. In the second place, in all cases where 
unilateral illumination is practiced, the desks immediately adjacent 
to the windows at times receive illumination of so great an intensity 
that it is hard to regulate without throwing a part of the classroom 
in shadow. The situation is comparable to artificial lighting, where 
better illumination is secured by the proper distribution of a number 
of small lighting units than by the use of a few concentrated units. 
Two-sided classroom illumination, by windows to the left and rear 
of the seated pupils, is therefore preferable. This arrangement 



DAYLIGHT ILLUMINATION OF CLASSROOMS. 41 

secures a more uniform light distribution which may be more easily 
regulated with respect to intensity than is the case with unilateral 
illumination. 

The sole reasonable objection to this arrangement of classroom 
windows is the annoying effect on the teacher, who is usually seated 
facing windows when they are located in the rear walls of the 
classroom. There is no valid reason for this usual arrangement of the 
teacher's desk, which seems to be a matter of hoary custom. The 
above-mentioned disadvantages are obviated readily by placing the 
teacher's desk diagonally in the left front of the classroom, causing 
the teacher to face in a direction opposite light sources when seated, 
at the same time permitting supervision of the seated pupils. 

The accompanying chart (5) is a gi-aphic representation of the 
direction of classroom illumination and the relative proportion of 
109 classrooms lighted from one, two, or more directions. The 
periphery of the dark sphere here shown represents 109 classrooms 
to be illuminated, and the light segment the proportion of classrooms 
receiving light from a particular direction. It will be seen from 
this chart that the greatest number of these classrooms were lighted 
by windows placed to the left. The next greatest number by win- 
dows to the left and rear, 18.8 per cent and 27.2 per cent of the 
total number respectively. In other words, daylight was admitted 
to classrooms from a desirable direction in only 46.2 per cent of the 
rural classrooms of this county. 

Of the classrooms in which windows were improperly located with 
respect to the desk arrangement, 20.5 per cent had cross illumination 
from right to left, 5.8 per cent right and rear, 21.2 per cent, left, 
right, and rear, and practically 3 per cent had windows on all four 
sides. In one school the light was received from the rear; in one 
from the front and left, and in two schools it was from the front, 
right, and rear. In nearly all these schools with faulty window ar- 
rangement, it would be practicable to close certain windows, enlarge 
others, and to modify the desk arrangement in a manner to secure 
better and more comfortable light at moderate expense. 

DIFFUSION OF LIGHT AND AVOIDANCE OF GLARE. 

The daylight illumination of classrooms is often defective because 
due measures have not been taken to secure the maximum diffusion 
of light entering such rooms. The diffusion of light depends upon 
the fact that all materials reflect light and under varying conditions 
scatter it in a greater or less degree. Some materials reflect nearly 
all the light diffusely, others specularly after the manner of a mirror. 
The ratio of diffusion to specularly reflected light by objects varies 
greatly according to the degree of surface polish and color. 



42 



RURAL SCHOOL SANITATION. 





Left 5ided illumination. 



Left sided and rear 
illumination. 





Left and right sided 
illumination. 



Rear AND right 51DEO 

ILLUMINATION. 





Left and right si ded and Left and right sided, front amo 

REAR illumination. REAR ILLUMINATION. 

U.S. Public Health Service 



Chart S.^Relatlve position of windows in Porter County classrooms. (Explanation of 

chart in text, page 41.) 



DAYLIGHT ILLUMINATION^ OF CLASSROOMS. 43 

Types of diffusion. — The measures necessary to secure the proper 
diffusion of light will be better understood in connection with a 
clear conception of what is meant by types of diffusion. The follow- 
ing definitions are taken from the report of a committee of the Illu- 
minating Engineering Society on the " Optical Properties of Diffus- 
ing Media : " ^ 

1. Specular reflection is tliat exhibited on a plain, polished surface, neither 
scratched, dirty, wavy, nor, if not opaque, reflecting diffusely within the surface. 

2. Partly specular diffusion is the reflection of light in which a distinct 
image of the source may be seen, as by a dusty mirror, or sheet of glass over- 
lying paper, 

3. Near diffuse reflection is when the specular image is completely broken 
up, yet the diffusion is far from complete. Reflection from calendared paper 
and other wavy surfaces is of this class. 

4. Diffuse reflection is Avhen a surface is uniformly illuminated and appears 
equally bright, viewed at all angles of reflection. Blotting paper, felt, snow 
and other masses of fine crystals exhibit nearly perfect diffuse reflection. 

This latter is the desirable type of light reflection in interiors. 
The more completely light is diffused the greater will be the avoid- 
ance of glare. 

Glare. — Glare, as ordinarily defined, is a condition of reflection 
arising when the brightness of an object reflected peripherally on 
the retina is relatively greater than that of the object whose image 
is centered on the yellow spot. 

In the report of the Illuminating Engineering Society on " Diffuse 
Media — Interior Furnishings,"^ glare has been classified, as in- 
volved in interiors, into — 

(1) Brightness glare. — Excessive brightness, such as occurs with the sun 
shining directly on snow, white paper, or a white window shade. 

(2) Contrast glare. — Contiguous bright and dark objects cause disturbance 
of vision if their relative brightness is excessive. A bright illuminant viewed 
against its background, a dark window frame against sky or landscape, and 
glare exhibited on a glossy surface are familiar examples. 

(3). Veiling glare. — That condition in which the surface to be observed ap- 
pears covered with a light or dark veil of different or imperceptible pattern, A 
blackboard viewed from near the specular angle, wlien imperfectly located 
with respect to windows, often furnishes this type of glare. 

Glare is observed when light rays are nearly parallel to the eye 
level. Therefore, light sources situated above this level are more 
likely to be free from glare. For this reason the lower edge of the 
classroom windows should be well above the visual level of the seated 
pupils.^ 

1 Transactions of the Illuminating Engineering Society, July 20, 1915. 

3 The Boston school code requires the lower window sill to be 21 feet from the floor, a 
distance not considered high enough from the standpoint of illumination. This distance 
is fixed by other authorities at 3.75 feet to 4 feet. 



44 



RURAL SCHOOL SANITATION. 



Furthermore, the more diffusely light is reflected and the lower the 
ratio of specular reflection thereto, the greater is the freedom from 
glare. Certain polished surfaces, largely influenced by their color, 
reflect light in a specular manner. The side walls of a schoolroom, 
therefore, should have a mat surface free from gloss. In the case 
of ceilings, however, no such objection exists, because the light re- 
flected therefrom is at the greatest possible angle to the visual level, 
and therefore not likely to produce glare. 

Classroom walls should also be colored in a manner to obtain re- 
flection with a maximum of diffusion. For this reason shades of the 
primary colors, yellow and green, found near the center of the lumi- 
nous portion of the solar spectrum, are selected because they not only 
have a high reflection coefficient, but possibly absorb other rays of the 
spectrum not concerned in illumination which may be injurious to 
sight. * 

The use of a white coloring for the side walls of schoolrooms is 
objectionable because of glare, although the reflection coefficient is 
high. Its employment for ceilings, however, is admissible because 
the angle of reflection therefrom is nearly perpendicular to the visual 
level in classrooms of ordinary dimensions. 

In 46 classrooms both the walls and the ceilings were painted 
green. Unfortunately the shade of green selected in many instances 
was so dark as to appear almost black, so that the light absorption 
thereof markedly diminished the illumination of said classrooms. 

In 20 classrooms the walls and ceilings were both white. This is 
undesirable because of the eye discomfort induced by the high re- 
flection coefficient of these surfaces at a level parallel to the eye. 

In three classrooms both walls and ceilings were painted blue, and 
in three other instances were painted pink. 

Some interesting combinations of color from the standpoint of 
undesirability were foimd in 13 classrooms. The most striking of 
these were green walls with natural wood ceilings in three instances ; 
green and blue in two others; white and blue in one, and green and 
pink in one instance. These combinations are not pleasing to the 



» The following table of coefficients of reflection is given by Harrison and Anderson (Transactions of the 
niumlnating Engineering Society, Sept. 23, 1915): 


Ceiling. 


Walls. 


Floors. 


Color. 


Per cent. 


Color. 


Per cent. 


Color. 


Per cent. 


White 


81.0 

64.0 

33.0 

4.3 


White 


81.0 

42.5 
4.3 


White 


84.0 




Medium 




14.0 




Black 


Black 


7.6 


Black 



















DAYLIGHT ILLUMINATION OF CLASSROOMS. 45 

eye, and a number of the ceilings have a very low reflection coefficient 
instead of a high one. 

Wainscoting of wood was found in 50 classrooms. In eight others 
the lower part of the wall was painted a darker shade to a height 
ranging from 48 to 54 inches. The average height of wainscoting 
in all the schools of the county was 38.5 inches, ranging from 31 to 
60 inches. 

The ceilings of classrooms were of metal in 16 instances, wood in 
5, and were papered in 2 schools. The side walls were papered in 
4 schools. For sanitary reasons schoolroom walls should not be 
papered. 

In 39 classrooms the wall and ceiling surfaces were gloss, mat in 
61, and a combination of mat walls with gloss ceilings in 8 others. 

In view of the definite value of proper illumination as an aid to 
the educator, the data relative thereto collected during this survey 
clearly emphasizes the need of scientific advice in planning the 
natural illumination facilities of schools. The average builder can 
not be relied on to plan buildings for educational purposes. In a 
matter apparently so small as the finish and coloring of classroom 
walls, this survey shows the need of due consideration of the prin- 
ciples of illumination rather than deference to the individual liking 
of school trustees or other influential persons. The cost of redecorat- 
ing every classroom in the county where the color and finish were 
found objectionable would be small in comparison to the increased 
attractiveness and illumination efficiency. 

REGULATION OF INTENSITY OF CLASSROOM ILLUMINATION. 

It has been shown in another place in this report (see p. 22) that 
the orientation of school buildings is largely influenced by the de- 
sire to admit sunlight to all classrooms during some hour of the day. 
Direct sunlight shining on bright paper, books, and the like, however, 
will cause brightness glare. This may be avoided by the use of 
translucent window shades backed by another shade which is opaque 
to shut out direct sunlight. Window fixtures should be of a type to 
permit the adjustment of window shades from either the top or bot- 
tom of the window. 

HEATING OF CLASSROOMS. 

Under modern conditions the problems of heating and ventilation 
are so closely associated that either question can scarcely be consid- 
ered separately in the planning and erection of school buildings. 
This is due to the necessity of warming fresh air introduced into 
classrooms in cold weather to replace that removed in the course of 
ventilation. 



46 RURAL SCHOOL SANITATION. 

The physical laws which govern heat demand careful observance 
in the planning of buildings and form problems which require the 
assistance of skilled engineers whenever large installations are to be 
made. School trustees and principals, however, should acquire a 
certain familiarity with the general principles involved, to enable 
them to appreciate the necessity of expenditures for this purpose 
and to act intelligently. 

EFFICIENCY OF DIFFERENT TYPES OF HEATING APPARATUS. 

Grates. — It has been said that the best form of open grate gives 
only 20 per cent of the heating value of fuel. The intensity of heat 
from a grate varies inversely as the square of the distance from the 
source. Furthermore, the air of a classroom is not warmed directly 
by radiated heat, which passes through it without raising its tem- 
perature. For this reason an open fire warms surfaces of the body 
directly exposed to radiation only, while the rest of the body remains 
cold. An open fire acts, however, as an effective means of ventila- 
tion in rooms of reasonable size. It also causes a minimum reduc- 
tion in the relative humidity of the confined air. Open fires may be 
appropriately utilized for heating classrooms in small mining towns 
and other localities where the fuel supply is plentiful and cheap. 

Stoves. — From an economic standpoint the closed stove is the most 
effective method of warming rooms. The modern base burner is 
said to utilize YO to 80 per cent of the fuel value of coal. Stoves 
heat by direct radiation from their surfaces and by convection due 
to changes in the weight of air heated by contact. It is of interest 
to note in this connection that the radiation of heat by stoves, and 
by radiators as well, is not influenced by their form, but that this 
power is affected by the color and condition of the radiating sur- 
faces. In this respect polished surfaces radiate less heat than rough 
ones, and surfaces painted with lampblack or similar material radi- 
ate greatly in excess of those that are not. 

The objection to closed stoves is due to the space occupied by 
them, the dust and dirt occasioned by their care, the difficulty of 
regulating temperatures, and the harmful influences on atmospheric 
conditions in confined spaces. 

Closed stoves were used for heating purposes in 31 instances, or 
in 41.1 per cent of the rural schools. 

The use of these stoves is usually accompanied by wide fluctua- 
tions in classroom temperatures and variations in different parts of 
the classroom at the same time, which are incompatible with physical 
comfort and educational effort. 

The average temperatures observed in 21 schools so heated was 
68.5° F., ranging from 59° F. to 81° F. These extremes of tempera- 



HEATING OF CLASSROOMS. 



47 



ture, even though temporary, emphasize the difficulty of maintain- 
ing an equable temperature with this type of heating apparatus. 

The use of the closed stove, furthermore, is accompanied by great 
reduction in the relative humidity of the classroom atmosphere. No 
steps had been taken in any of these classrooms inspected to obviate 
this condition. Measures usually adopted for this purpose in con- 
nection with closed stoves are far from adequate; but their use has 
an educational effect and serves to impress the pupils with the hy- 




U. S. Public Health Service 

Fig. 7.— Type of jacketed stove. 

gienic value of a requisite amount of moisture in the air of class- 
rooms and homes. 

Jacketed stoves. — An attempt to overcome the defects of heating 
by closed stoves, and at the same time retain their economic heating 
efficiency, is seen in the so-called jacketed stoves now in use in quite 
a number of rural schools, a type of which is shown in figure 7. The 
outside air is introduced directly to a space between the stove and a 
jacket surrounding it. The air expands on coming in contact with 



48 EUKAL SCHOOL SANITATION. 

the warm surface, rises, and carries heat to all parts of the class- 
room. The advantages of this method of heating are largely those 
of ventilation. These will receive further consideration under the 
proper caption (p. 54). 

Jacketed stoves were installed in 26 instances or in 34.5 per cent 
of the rural schools of the county. 

The care of jacketed stoves is more complicated than that of the 
ordinary closed type. The fresh-air connections were broken, dis- 
connected, and otherwise rendered useless in a number of instances, 
so that the air supplied was drawn either from the building or cut 
off altogether. As a result the combined efficiency of the heating 
plant was reduced to that of the closed stove. Moreover, collections 
of dirt and other debris were found accumulated in the spaces sur- 
rounding the stove and its jacket and in a number of instances in the 
air supply pipes. 

The average temperature of 22 schools heated in this manner was 
74° F., the extremes being 65° F. and 85° F. All parts of the class- 
rooms, however, were heated in a more uniform manner than with 
the closed stove type. 

Humidifiers were attached to these stoves and were in use in 11 
schools. The average amount of water evaporated from receptacles 
in 10 schools employing them was 1.25 gallons per diem, an amount 
so small as to make but little impression upon the relative humidity 
of the air in an average classroom. The humidifiers usually met with 
in connection with stoves of this type are too small and are badly 
located. 

Hot-air furnace. — The hot-air furnace is essentially a stove the 
heating surface of which is inclosed in a case with a space separating 
the two. Through this space the air from outside sources circulates 
and when warmed rises to the points of distribution. The furnace 
is usually located in the cellar, and the heated air is conducted by 
flues to the various rooms. These heating flues are usually covered 
by a grating where they enter the classroom. The total area of the 
openings in the grating should equal that of the cross section of the 
conducting flue. The register, as the grating is called, should be 
fitted with a damper, by which the flow of heated air may be reg- 
ulated. 

The circulation of air takes place because of the difference in the 
weight of the heated air inside and of the air outside of the con- 
ducting flues. This difference in weight is small; consequently, in 
installations where the furnace or conducting flues are improperly 
located certain classrooms are insufficiently warmed during stormy 
weather, depending on the intensity and direction of the wind. 



HEATING OF CLASSROOMS. 49 

The efficiency of a hot-air furnace, when the air to be warmed is 
taken from the outside, is said to be 50 to 60 per cent of the heating 
value of the f uel.^ 

Temperatures in 15 classrooms, heated in this manner, were re- 
corded, the average being 73.5° F., and the extremes 67° and 84° F., 
respectively. 

Hot-air furnaces were installed in 16, or 21.1 per cent, of the 
schools of the county. The air used for purposes of warming was 
carried by gravity to the classrooms of 10 schools, or 62.5 per cent of 
those warmed by this system. In 6 other schools the hot air was 
introduced to the classroom with mechanical assistance. 

Temperature observations were also made in 12 classrooms in 4 
schools, where mechanical aids to hot-air conduction were employed. 
The average temperature of 12 classrooms was 72.5° F., the extremes 
being 70° and 79° F., respectively. 

The humidification of the classroom atmosphere in all these schools 
was entirely inadequate. 

Steam and hot-water heating. — In but two schools of the county, 
Kouts and Porter, were steam or hot-water systems used. The ad- 
vantage of these systems lies in the ease and certainty with which 
heat may be conveyed from a central plant to distant points, practi- 
cally uninfluenced by the force and direction of the wind. 

From the standpoint of ventilation, however, direct heating by 
steam or hot water differs but little from the closed stove. The 
efficiency of direct steam or hot-water heating is said to be 60 to 
70 per cent. 

Direct hot-water heating has certain advantages over steam, due 
to the circulation of the former taking place at a lower temperature, 
namely, about 140° F. for hot water and 212° F. for steam. Hot- 
water plants, therefore, begin yielding heat much more quickly 
after starting the fire than is the case with steam and continue to do 
so for a longer period after the fire has died down. Furthermore, by 
reason of these characteristics of hot-water heating, a more uniform 
temperature may be maintained in rooms heated in this manner. 

1 Certain rulos which give approximate results have been devised for the guidance of 
those unable to obtain expert advice with respect to hot-air installation (John R. Allen : 
Heating and Ventilation) : 

1. The volume of the house divided by 50 equals the square feet of heating surface in 
a furnace radiator. 

2. The volume of the house divided by 20 equals the number of square inches of grate 
area in the furnace. 

3. Divide the volume of the room by 20 and the square root of the quotient will be 
the diameter of the furnace pipe for the first-floor rooms. For the second-floor rooms, 
divide the volume by 25, and the square root of the quotient will be the diameter of the 
furnace pipe. 

It must be emphasized that rules of this character give only approximate results. The 
necessity of some easily calculated standard to supersede the hit-or-miss installations so 
commonly found in these schools is apparent in many rural communities, 

38062°— 16 4 



50 



EUKAL SCHOOL SANITATION. 



TEMPERATURE REGULATION IN CLASSROOMS. 

Objection has been made to the maintenance of a uniform class- 
room temperature because, by so doing, certain stimuli habitual to 
ordinary everyday environment are removed; as, for example, the 
effects of variations in heat and cold on the blood pressure. This 
stimulation is doubtless of considerable value in certain general dis- 
orders, v\diere education assumes a position of secondary importance. 
In the case of healthy children, however, the maintenance of a desir- 
able uniform temperature in a healthful environment is unobjection- 
able from the standpoint of health and is most conducive to mental 
application, by removing the physical stimulation in question. 

The temperature usually advocated for classrooms in this country 
varies from 68° to 70° F. This standard, however, may be modified 
by climatic conditions. For example, 60° to 65° F. is considered a 
desirable indoor temperature in England, where the climate is uni- 
form and the air is of high relative humidity. Similar conditions 
are found in localities in this country, in which places the main- 
tenance of classroom temperatures should be regulated accordingly. 
Variations in either direction from this standard cause physical dis- 
comfort incompatible with the best mental effort. 

The maintenance of classroom temperatures above 70° F. is an 
economic loss through increased coal consumption. In schools in 
which no provision is made for heat control an unnecessary amount 
of fuel is consumed and heat is wasted through doors and windows 
opened for cooling purposes. 

Temperature observations^ in individual schools and classrooms 
are recorded in the following table : 



Table I.- 



-Atmospheric conditions in 72 classrooms in the rural schools of Porter 
County, Ind. 



Township and school. 



Boone: 

Aylesworth 

Bryant 

Prye 

Hebron, 1 

Grades 1-2, 2. 

Grades a-'), 3. 

Grades 5-6, 4 . 

Grades 7-8, 5 . 

Tannehill 

Center: 

Cooks Corners 

Flint Lake 

Leonard 



Tempera- 
ture. 



Carbon 
dioxide 

per 
10,000. 



2-6 

8.75 



Relative 
humidity. 



Per cent. 



0.44 
.53 
.44 
.41 
.69 
.47 
.47 
.35 

.31 
.18 
.21 



Humidi- 
fier. 



Water 
evapo- 
rated 
daily. 



Gallons. 
1 



1 A number of temperature observations made in this survey were discarded because, the 
weather being mild, they represented outside atmospheric conditions rather than methods 
of heat regulation. 

?-6=Iess than 6 quarts per 10,000. 



HEATING OF CLASSROOMS. 



51 



Table I. 



-Atmospheric conditions in 72 classrooms in the rural schools of Porter 
County, Ind. — Contiuued. 



Township and school. 



Tempera- 
ture. 



Jackson: 

Burdick 

Carter 

Coburg 

County line 

Jackson Center, 1 

Grades 1-2 

Grades 7-8, 2 

Quakerdom 

Liberty: 

Babcock 

Coles 

Crocker 

Liberty *Center"(H.' S.')', Y." 

Grade2 

Linderman 

Phares 

Salt Creek 

Morgan: Schroeder 

Pine: 

Bayles 

Brick 

Carver 

Frame 

Smoky Bow 

Pleasant: 

Kouts, H. S. (H. S.), 1... 

Grades 6-7, 2 

Grades 4-5, 3 

Grades 2-3,4 

Grade 1, 5 

Lauer 

Morrison 

Stowell 

Portage: 

Crisman (high) 

Grades 1-2 

Grades 3, 4-5 

Grades 6, 7-8 

Dombey 

McCool 

Peak 

WoU 

Porter: 

Gates Comers 

Hurlburt 

Porters Cross Roads 

Skinner 

Union: 

Cherry Glenn 

Foster 

Peck 

Union Center — 

Grades 1-4 

Grades 5-8 

Wheeler- 
Grades 1-2 

Grades 3-5 

Grades 6-8 

High School 

Washington: 

Blake 

Bryerly 

Luther 

Washington Township — 

Grades 1-6 

Grades 7-8 

Westchester: 

Baileytown 

City West 

Furnessville 

Mosquitotown 

Old Porter 

Salt Creek 

Waverly 



■ F. 



Average . 



Carbon 
dioxide 

per 
10,000. 



-6 

8.5 
-6 

7 
-6 



-6 
-6 



10 
-6 
-6 
-6 
-6 

8.15 
-6 



7.5 
10 
10 



-6 
-6 
-6 
-6 
7.5 
-6 

5.2 

8 

8.2 

6.5 

8 

7.5 

7.5 



.59 



8.5 

-6 
-6 
-6 



7.5 
8.75 
-6 
9 



9.15 



Relative 
humidity. 



Per cent. 
0.21 
.32 
.29 
.52 
.52 



.35 
.46 
.31 

.27 
.30 

.40 
.27 
.41 
.41 

.46 
.34 
.44 

.25 
.25 

.56 
.40 
.35 
.53 
-.27 
.38 
.41 

.363 



Humidi- 
fier. 



15 



Water 
evapo- 
rated 
daily. 



Gallons. 



1.5 
1.0 



1.5 

5 
5 
5 
5 



1.75 
1.4 



1 Quarts. 



52 RURAL SCHOOL SANITATION. 

The widest variations in classroom temperatures were observed in 
schools heated by closed stoves, the average being 68° F. and the 
highest 81° F. Furthermore, the temperature varied in different 
parts of these classrooms, according to the distance from the stove. 

Considerable variations of classroom temperatures were observed 
in all cases where heating was by jacketed stoves and hot-air fur- 
naces located in basements. The average temperature in the former 
was 74° F. and in the latter 73.5° F., the highest being 85° F. and 84° 
F., respectively. The warming of all parts of these classrooms was 
more uniform than by either of the other methods discussed. These 
observations, however, plainly indicate the maintenance of too high 
classroom temperatures at times and undue fuel consumption. These 
faults are due, in part, to the type of heating system installed and in 
part to careless supervision. 

Variations in the temperature in the classrooms warmed by hot 
air, mechanically assisted, were unnecessarily great. This was usu- 
ally due to the absence of automatic temperature regulators. 

Measures. — The efficiency of regulating temperatures where the 
closed stove is used depends largely on the care and attention given 
by some competent person, the size of the stove in relation to the 
cubic capacity of the classroom, the fuel used, and the material used 
in the building construction and its state of repair. The use of 
closed stoves in one-room rural schools, though economic from the 
standpoint of fuel consumption, is being rapidly abandoned be- 
cause of the difficulty experienced in securing constant temperatures 
and the harmful influence of the stoves from the standpoint of ven- 
tilation. 

The regulation of temperature in the case of hot-air furnaces 
supplying heat by gravity is accomplished by the proper adjustment 
of dampers in supply pipes and furnaces, and through due attention 
to the installation of conducting flues in inside walls protected, so far 
as possible, from outside atmospheric influences. Furthermore, the 
size of the furnace in use contributes largely to the uniformity of 
classroom temperatures. A furnace which has to be fired until it 
becomes red-hot to secure a desirable classroom temperature is too 
small for the building. 

Steam, hot water, and mechanically assisted hot-air heating sys- 
tems readily lend themselves to the use of automatic devices for 
securing constant classroom temperatures. The essential feature 
of an automatic heat regulator consists of a thermostat so constructed 
that its parts will move with a change of temperature in the sur- 
rounding air and furnish power to operate the air valves or electric 
contrivances which cause the opening and closing of valves or 
dampers of the heating system involved. The great advantage of 



HEATING OF CLASSROOMS. 53 

an automatic temperature control device, aside from securing a con- 
stant classroom temperature, is that the heating of classroomrf is re- 
moved from the control of teachers and therefore uninfluenced by 
personal bias or judgment. The expense of temperature regulating 
installations, though considerable, is more than counterbalanced by 
the saving in fuel consiunption incident to a regulated classroom 
temperature. 

Electrothermic indicators are of value for the regulation of class- 
room temperatures in schools where full-time janitors are employed. 
By means of this indicator the janitor can instantly determine the 
temperature in any classroom from a point near the furnace and 
thereby determine defects or disarrangement of the automatic heat- 
regulating system which require attention. 

The jacketed stove remains the best solution of classroom heating 
in the one-room rural schools. The system of hot-air heating by a 
centrally-located furnace in the basement is particularly adapted to 
local conditions in isolated rural schools of more than one room. 
Heating by hot water and steam requires gi-eater care and attention 
between the closing and opening hours of school than is usually 
available for schools so situated. Wliere gravity is relied on to 
carry the air, the use of a hot-air system of heating is limited to the 
classrooms of schools compactly built and covering comparatively 
small ground areas; otherwise the inclination of certain conducting 
flues will be so great that the forces of gravity inducing air currents 
will be nearly equalized. 

VENTILATION. 

GENERAL CONSIDERATIONS. 

The injurious effects of more or less prolonged exposure to condi- 
tions of imperfect ventilation in restricted spaces such as assembly 
halls and classrooms are well recognized. The exact manner in 
which these influences operate to cause injury, however, is not easily 
explained and concerning it there exists considerable difference of 
opinion. 

Recent investigations tend to show, however, that the injurious 
results of confined air in crowded places are due to certain physical 
changes, involving temperature, humidity, and movement of the air 
in these confined spaces, which operate to create disturbances of the 
heat regulation of the body and cause variations in the blood pres- 
sure. The manner in which these disturbances affect health is not 
thoroughly understood at present. 

It matters not whether one accepts the theory that confined air 
spaces vitiated through human occupancy contain some harmful 



54 EUEAL SCHOOL SANITATION. 

substances which require removal or the contention that the sole 
necessity, from the standpoint of ventilation, is to keep the air cool 
and in motion, the fact remains that the requirements demanded of 
a satisfactory system of ventilation are an abundance of outside air, 
not unduly heated, properly moistened, and free from mechanical 
impurities; in other words, a supply of air approximating natural 
conditions as closely as possible. 

Changes of air. — Although the discomfort induced by a " close " 
atmosphere may be dispelled by setting the air in motion, and under 
certain restrictions a confined atmosphere can be rebreathed without 
appreciable harmful effect, after being washed and deodorized, 
nevertheless, for the purposes of practical ventilation, the necessity 
remains to supply a definite volume of air to densely populated 
classrooms. 

Supply of air necessary for classroom purposes. — The calculation 
of the requisite volume of air necessary to supply a classroom under 
given conditions for practical purposes is based on certain composi- 
tional differences between air before and after respiration, repre- 
sented by the amount of carbon dioxide present. 

For the want of more precise knowledge of the influences of the 
volume of the air in ventilation, an arbitrary standard has been 
adopted which requires fresh air to be supplied in volume sufficient 
to keep the amount of carbon dioxide down to not more than 6 parts 
in 10,000. 

The accepted requirement heretofore has been that each pupil 
should receive 30 cubic feet of air per minute, or 1,800 cubic feet per 
hour. The number of air changes per hour necessary to supply this 
amount depends on the cubic capacity of the classroom and the 
number of pupils. The cubic space allotted each child should be 
large enough to demand not more than six changes of air per hour 
in order to avoid objectionable drafts. The Indiana law provides 
225 cubic feet of space for each child, the floor space in each case 
being 20 square feet. 

Carbon dioxide was present in seven classrooms to the extent of 8 
parts in 10,000 and in four classrooms to the extent of 10 parts in 
10,000. In other words, fresh air was admitted to a large number 
of rural classrooms in deficient amounts, as represented by these 
figures. The number of carbon dioxide determinations was limited, 
due to several causes, principally the advent of warmer weather, fol- 
lowed by more open windows. 

Methods of securing requisite air allowance. — There are two gen- 
eral methods of ventilation : namely, the gravity system, or so-called 
natural ventilation, and mechanical ventilation, with the use of 
fans. In addition to these two general ventilating systems, window 



VENTILATION. 



55 



ventilation, jacketed stoves, perflation, window sash openings, flues 
in the ceiling leading to loiivered outlets and other forms of ven- 
tilators in the roof, perforated bricks, or other openings are aids to 
ventilation which may be employed in small one-room schools. With 
respect to the relative advantages of these various systems, those 
that ventilate by means of open windows and other similar devices 
are more healthful. Mechanical ventilation presupposes closed win- 
dows, a disadvantage from the standpoint of hygiene. The advan- 
tages of this system of ventilation, however, are due to the ability 
to deliver air in definite quantities at a given rate to a particular 
place, to take it from a selected source, to warm it to the desired 
temperature, to wash and free it from mechanical impurities, and 
to add a desired percentage of moisture. 

Mechanical ventilation. — In all systems of mechanical ventilation 
due attention must be given to the installation of conducting air 
flues, their size, the friction and velocity of air currents — matters of 
technical detail requiring the attention of skilled engineers. In 
general, the size of the conducting pipe should be calculated to sup- 
ply not less than 1,800 cubic feet of air per pupil per hour, or six 
changes per hour, as the case may be, with a velocity of the air cur- 
rent at the register of not more than 300 feet per minute. In the 
case of very large registers, so located that the air current will not 
strike the pupils directly, a velocity as great as 500 feet per minute 
is said by ventilation engineers to be permissible. 

Rate of air exchange. — In Table 2 is shown the rate of air ex- 
change in 33 classrooms of Porter County, as determined by actual 
measurements with an anemometer : 

Table II. — Rate of air exchange in 33 classrooms of the rural schools of Porter 

County, Ind. 



Township. 



Boone.. 

Center. . 
Jackson 

Liberty. 

Pine 



School. 



Hebron: 

High School.. 

Grades 1-2. . . 

Grades 3-4... 

Grades 5-6 . . . 

Grades 7-8... 

Leonard 

Carter 

County Line 

Jackson Center: 

Grades 1-2. . . 

Grades 7-8. . . 

Crocker 

Daley 

Liberty Center: 

High School.. 

Grades 

Smoky Row 



Total. 



Inlet 

per 

second. 



Cu.ft. 
32.45 
17.98 
22.80 
19.72 
36.20 
15.39 



1.73 

30.00 

34.00 

4.59 

4.62 

25.20 
22.80 



Outlet 

per 
second. 



Cu. ft. 
34.80 
34.65 
12.40 
19.53 
23.78 



3.59 
1.92 



26. 35 
24.18 



25.30 
3.80 
1.33 



Per pupil. 



Inlet 

per 

second. 



Cu.ft. 

0.53 

.45 

.69 

.73 

1.81 

1.02 



.10 

1.50 

2.62 

.19 

.26 

1.15 
1.14 



Outlet 

per 
second. 



Cu.ft. 

0.57 
.87 
.38 
.72 

1.19 



.18 
.11 

1.32 

1.86 
.04 



1.15 

1.90 

.06 



Per desk. 



Inlet 

per 

second. 



Cu.ft. 

0.44 
.43 
.54 
.66 

1.34 
.51 



.09 

1.50 

1.10 

.13 

.11 

.84 
.95 



Outlet 

per 
second. 



Cu.ft. 

0.48 

.82 

.30 

.65 



.14 
.10 

1.32 

.78 
.03 



.84 
.16 
.05 



56 



RURAL SCHOOL SANITATION. 



Table II. — Rate of air exchange in 33 classrooms of the rural schools of Porter 
County, Ind. — Continued. 





School. 


Total. 


Per pupil. 


Per desk. 


Township. 


Inlet 

per 

second. 


Outlet 

per 
second. 


Inlet 

per 

second. 


Outlet 

per 
second. 


Inlet 

per 

second. 


Outlet 

per 
second. 




Kouts: 

High School... 

Grades 6-7 

Grades 4-5 

Grades 2-3 

Grade 1 


Cu.ft. 
15.60 
8.28 
14.30 
19.15 


Cu.ft. 
17.16 
15.60 
16.90 


Cu.ft. 

0.30 

.30 

.41 

.58 


Cu.ft. 
0.33 
.56 
.48 


Cu.ft. 

0.26 

.19 

.29 

.42 


Cu.ft. 




0.29 
.36 
.34 




4.08 

10.80 
12.60 
8.82 
2.10 
15.40 
2.03 
1.82 

5.85 
8.64 
1.60 
4.50 
3.00 
.62 


.15 

.90 
.60 
.24 
.08 
.70 
.10 
.15 

.37 
.23 
.05 
.23 
.33 
.05 


.11 


Portage 


Crisman: 

High School... 

Grades 1-2 

Grades 3-5 

Grades 6-8 


18.85 
31.62 
21.70 
30.07 


1.57 

1.51 

.59 

1.16 


1.26 
.81 
.53 

.97 






.72 
.32 
.22 
.07 
.53 




McCool 








.05 




Wolf 


3.40 

8.25 
11.60 
11.20 

9.75 
19.78 


.28 

.52 
.31 
.32 
.49 
1.80 


.09 

.24 
.28 
.32 
.33 
.79 


.05 




Wheeler: 

Grades 1-2 

Grades 3-4 

Grades 7-8 

High School.. . 






.17 
.21 
.05 
.16 
.14 


Westchester 




.02 















The number of these observations was restricted owing to the early 
advent of spring and the discontinuance of fires. It will be seen, 
however, that the requisite number of cubic feet per minute is sup- 
plied in the Hebron, Jackson, and Liberty Center schools, where the 
Plenum system is in use. In other cases, where the systems depended 
on gravity, the amount of air supplied per minute for each pupil 
was largely deficient, if measured by accepted standards. It varied 
from more than the necessary amount in some classrooms of the 
larger schools to hardly any exchange in others, depending on the 
direction and force of the wind. 

Air space per pupil. — The smaller the cubic allotment per pupil, 
the greater will be the required number of air changes to secure due 
allowance of fresh air per hour. The space for each pupil should, 
therefore, never be less than 250 cubic feet with a floor space allow- 
ance of about 20 square feet. 

The air space and floor area per pupil in actual attendance at 
Porter County schools was greatly in excess of the usual require- 
ments, being 443 cubic feet and 36 square feet, respectively. Calcu- 
lations were also made on the basis of the number of desks observed 
in each classroom. According to this measurement the average air 
space and floor space for each desk were 285 cubic feet and 23 square 
feet, respectively.^ In other words, even with a full attendance, 
ample provision of air space was made in practically all of the 
schools of the county. 

1 The average number of pupils per classroom was 23.36 and the number of desks 33.5. 



VENTILATION. 57 

Inlets and outlets. — The actual and relative location of inlets and 
outlets in classrooms is important. Air circulated in a classroom 
rises to the ceiling, is cooled by coming in contact with the cold walls 
and windows, and falls to the floor. Inlets, therefore, should be on 
the inner wall of the classroom, so that the current of fresh air 
entering is directed toward the outer wall. The location of the inlet 
should be high enough to be well above the breathing level of the 
pupils — usually about 8 feet above the floor. The outlet should be 
on the same side of the room as the inlet ; it should be high enough 
from the floor to avoid accumulations of dust and dirt. The size 
of the inlets and outlets is also of importance and can be calculated 
either with respect to the cubic capacity of the classroom or the 
number of pupils to be supplied with fresh air at a given velocity at 
the register. Tables for this purpose are to be found in works on 
ventilation. 

The minimum size of inlets and outlets given by various observers, 
on an empirical basis, varies from 2^ to 24 square inches for each 
pupil. Certainly an area of 2^ square inches would call for air 
delivered at very high velocities, which is undesirable from the stand- 
point of both comfort and economy. Wlien practicable, the outlet 
should be larger than the inlet. 

Of Go classrooms noted, 43, or 68 per cent, were provided with 
inlets of too small area. In no instance was the area of the extract- 
ing flue used in connection with jacketed stoves (similar to the one 
shown in fig. 7, p. 47) great enough to make much impression on 
atmospheric conditions in the classrooms. No mechanical ventilat- 
ing devices were found in use in any of the schools of the county 
heated by stoves. 

The ventilation of 27.6 per cent of the classrooms of the county de- 
pended entirely upon the natural circulation of the air through the 
walls, window openings, and crevices of various kinds. The Plenum 
System of ventilation was employed in ventilating 20.8 per cent of 
the classrooms and the gravity system, which included the use of 
jacketed stoves, in 51.6 per cent. 

HUMIDITY. 

The humidity of the surrounding air assists in the maintenance of 
uniform bodily temperature and, in desirable amounts, operates to 
promote bodily comfort, to increase resistance to disease, and to 
reduce fuel consumption. 

A dry classroom atmosphere is harmful to the respiratory appa- 
ratus, because of the absorption of moisture of the respiratory 
mucous membrane, causing dryness and fissures through which the 
infectious agents of respiratory diseases may gain entry. 



58 RURAL SCHOOL SANITATION. 

The effect of high humidities in a warm atmosphere, on the 
other hand, tends to cause heat stagnation and a disturbance of heat 
elimination from the body, inducing the well-known feeling of dis- 
comfort experienced on humid summer days. 

Desirable classroom humidities. — The question of the most de« 
sirable humidity for classroom purposes is not fully determined. 
Certainly a very high humidity in cold weather is liable to cause 
undesirable condensation of moisture on windows and outside walls. 
It is agreed quite universally, however, that, depending on the out- 
side temperature, a relative humidity below 35 per cent is injurious, 
50 per cent is desirable, and 70 per cent at 70° F. causes no harm. 

The greater number of classrooms had a relative humidity of less 
than 40 per cent. Furthermore, 41.7 per cent of these classrooms 
had a relative humidity of 35 per cent or less, largely due to failure 
to provide and utilize measures intended to obviate this condition. 
Humidity determinations were made by the use of a sling psychrom- 
eter. 

Measures for regulating humidity. — Cold air contains less mois- 
ture proportionately than warmed air. During cold weather it 
becomes necessary, therefore, to add moisture to heated air used for 
ventilating purposes. For example, to supply a classroom of 35 
pupils with 1,800 cubic feet of air each per hour at 70° F., with a 
relative humidity of 70 per cent for seven hours, would require the 
evaporation of over 30 gallons of water, when outside air is taken 
at a temperature of 30° F., with a relative humidity of 70 per cent. 
The futility of pans on stoves and radiators for the purpose of 
securing the necessary humidification of classroom atmospheres is 
evident. In fact, as mentioned in the section on heating, the humidi- 
fiers connected with the usual jacketed stoves were too small to sup- 
ply anywhere near the desired amount of moisture. They were 
located badly in most instances, being low down near the firebox, so 
that the air passed over them before being heated instead of after- 
wards, as should be the case. 

Use of humidostat. — One of the great advantages of mechanical 
ventilation is that it lends itself readily to the maintenance of a 
desirable relative humidity, which may be regulated by the humido- 
stat. This apparatus is arranged to act automatically. When the 
humidity in the surrounding air decreases it opens steam or water 
jets necessary to supply moisture to the incoming air and closes 
them when the required humidity is obtained. 

Air washing. — It has been found practicable by a system of air 
washing for the purpose of abstracting mechanical impurities also 
to supply necessary moisture, an excess of which can be abstracted 
in chambers arranged for that purpose. These measures are imprac- 
ticable in small rural schools. It has been shown by actual experi- 



VENTILATION". 59 

ment, however, that indoor humidity may be maintained as well by 
a judicious routine opening of windows as with the vise of mechan- 
ical devices. 

In large and consolidated schools, air washing may be econom- 
ically practiced, thus permitting the recirculation of inside air, 
heated by the so-called rotation method. This reduces coal con- 
sumption by obviating the necessity of taking colder outside air and 
heating it to the required temperature. The effect of recirculated 
air on health, however, has not been definitely determined. 

As stated in the section of this report devoted to heating (p. 48), 
no adequate attempts were made in any of the rural schools of the 
county to secure proper classroom humidities. 

DUST. 

Dust and other iinpurities. — Evidence has accumulated to show 
that there is less dust and bacteria in mechanically ventilated class- 
rooms than in those which are unventilated. As many as 256 bac- 
teria per cubic foot have been found by one observer in unventilated 
rooms, as compared to practically none in ventilated rooms. 

The effect of breathing dusty air is largely mechanical and results 
in excoriations and irritation of the mucous membrane that cause 
it to be receptive to the entry and lodgment of disease-producing 
organisms. 

Aerial infection with bacteria is possible only at very short dis- 
tances, and is largely due to the expulsion of infected particles by 
those harboring the germs of disease during sneezing and coughing. 
These suspended particles soon settle, however, and the majority of 
them become innocuous through drying. Nevertheless, the causative 
agents of tuberculosis and! pneumonia, when protected from oxida- 
tion by an albuminous coating derived from the secretions, may 
withstand drying for a long period and must, therefore, be removed 
by ventilating methods. 

Measures for eliminatiiig dust. — Air-washing stands at the head 
of the list of methods for removing the dusts from air used for 
ventilation. This method has been found more effective than the 
former practice of straining the outside air through burlap or some 
similar material. The use of devices of this character is restricted to 
large schools which have competent supervision, and is therefore not 
applicable to the rural schools of Porter County; but certain precau- 
tions may be taken to minimize the dust nuisance, of which the 
following are important: 

(1) Fresh-air intakes. — The location of fresh-air intakes has a 
definite bearing upon the amount of dust admitted to classrooms. 
In general, the fresh-air intake should be located on the warm side 



60 EUEAL SCHOOL SANITATION". 

of the school building — preferably the south. It is undesirable to 
locate the fresh-air intake close to the roof because of the danger of 
drawing smoke into the classroom. The intake should be of ample 
proportions to furnish an abundant supply of air, should be screened 
and elevated to a point well above the ground level. To exclude 
cellar air and the gases of combustion, all connections leading to 
the furnace should be tight. In all cases the fresh- air intakes should 
be screened to shut out coarse material which otherwise might plug 
the ventilating ducts. 

In no instance was the cold-air intakes of the schools of the county 
elevated more than 3 feet. A few of them were even below the 
ground level ; others were so situated and connected as to act as 
improvised vacuum cleaners for basements and spaces beneath the 
floors between the foundation walls. 

(2) Chalh troughs. — The use of troughs for the collection of pow- 
dered chalk and the avoidance of blackboard dust has been discussed 
in connection with classroom equipment (p. 34). 

(3) Door Ttiats. — In rural districts mud carried into the classroom 
on the children's feet is largely responsible for dust and dirt accumu- 
lations. Provision should be made for the purpose and children 
required to clean their boots and shoes before entering school. 

(4) Sweeping. — The frequency with which sweeping is done and 
the time and method of sweeping are of importance for controlling 
and preventing the accumulation of dust in classrooms. Sweeping 
should preferably be done after school hours; if before school, at 
least not later than one hour before the assembling of the pupils. 

In country schools during muddy weather, sweeping is necessary 
at more frequent intervals than once daily, in which case it should 
be done as long as possible before the assembling of classes in order 
that sufficient time may elapse for the settling of dust. Moist saw- 
dust and sweeping compounds might be used to advantage in places 
where vacuum cleaners are not available. 

(5) Dusting. — Schoolroom furniture requires careful attention to 
dusting. This procedure should follow sweeping regularly as soon 
as the dust has settled. In places where the sweeping is done after 
school hours, dusting could well be deferred until the following 
morning. A moist cloth should be used for this purpose, or prefer- 
ably a paraffin cloth or one moistened with kerosene. 

CLASSROOM CLEANING IN PORTER COUNTY SCHOOLS. 

Observations were made with respect to the janitor's service in a 
number of classrooms in the course of this survey. It was found 
that sweeping was done daily in 80 per cent of the schools, twice a 
week in 12 per cent, and three times a week in 8 per cent. Sweeping 
was done twice daily in 3 of the schools of the county. 



VENTILATION. 61 

Dry sweeping was practiced in 80 per cent of the rural schools, 
and the use of moist sawdust or sweeping compounds in the remain- 
ing 20 per cent. 

The time of sweeping was after school hours in 82.5 per cent of 
the schools, before school in 12 per cent, and at the noon hour in 4 
schools. 

Dusting was done in but 71 per cent of all the schools. Moist 
cloths were used for dusting purposes in 39 schools, dry cloths in 16, 
and a cloth which had been oiled in 2. 

The floors in 87 per cent of all the schools of the county had been 
oiled once during the year. The use of oil on floors for the elimina- 
tion of dust in classrooms is free from the danger of fire, provided 
the oil used for this purpose has a flash point not under 150°. 

ELIMINATION OF ODORS FROM CLASSROOlVf 8. 

The presence of odors in rural one- room schools is especially notice- 
able, due to rural conditions and rural occupations which occasion 
greater or less intimacy of contact w4th the stable, horses, and other 
domestic animals. The elimination of odors can be accomplished 
by the admission of ozone in due amounts to classrooms. It must be 
remembered, however, that an amount of ozone in the atmosphere in 
excess of 10 parts per million is incompatible with comfortable respi- 
ration and causes irritation of the eyes, nose, and throat. 

The use of ozonizers is impractical in these schools ; but this can be 
compensated for by routine opening of windows and other ventilating 
devices. 

OTHER MEASURES FOR SECURING OUTSIDE AIR CONDITIONS FOR SCHOOLS. 

In recent years the use of muslin screens in the place of the lower 
sashes and panes of glass is classroom windows has been advocated. 
This device is said to bring about classroom atmospheric conditions, 
comparable to outside air, that more than compensate for any addi- 
tional coal consumption occasioned by their use. Among the dis- 
advantages of this device may be mentioned the reduction of class- 
room illumination in certain localities by the accumulations of soot 
and dust on the screens. The suggestion, however, is worthy of fur- 
ther trial in selected rural communities where the surrounding air 
is comparatively free from mechanical impurities. 

Cold rooms. — The maintenance of a classroom temperature of 55° 
to 60° F. has been advocated in the case of children with latent non- 
communicable infections, anemic children, those with enlarged ton- 
sils and adenoids, mouth breathers, and children who take cold 
easily and are subjected to headaches from constitutional causes. 
Cold classrooms are also advocated for children who fail to make 
grade, especially when this is due to poor physical condition. 



62 RURAL SCHOOL SANITATION. 

Cold classrooms, however, are not desirable or demanded for nor- 
mal children from an educational standpoint. Their use in rural com- 
munities for the purposes outlined is necessarily restricted to con- 
solidated schools with attendance large enough to warrant this ar- 
rangement. 

Open-air schools. — No study of atmospheric conditions in connec- 
tion with school life would be complete without some mention of 
open-air schools. 

In certain chronic affections advantage is taken of the restorative 
action of open-air conditions upon health to combine it with edu- 
cation by the use of open-air schools. Schools of this character are 
especially desirable for children suffering from clinical tuberculosis 
and subnormal children received from a tubercular environment. 

CLOAKROOM ACCOMMODATIONS IN RURAL SCHOOLS. 

Probably no single feature of rural school construction has re- 
ceived so scant attention as the provision of appropriate conveniences 
for the care of wraps and other articles of extra clothing of school 
children. Frequently in the schools surveyed no cloakroom accom- 
modations whatever were observed, the classroom walls being utilized 
for this purpose. In other instances the cloakrooms were mere 
makeshifts, too small for the purposes intended, and also used as a 
storage place for discarded school furniture and other equipment. 

The need of suitable cloakroom accommodations is especially ap- 
parent in country districts, where children often travel considerable 
distances and are exposed for long periods to inclement weather con- 
ditions. The cloakrooms of country schools should, therefore, af- 
ford ample space for drying wraps. Furthermore, country school 
children necessarily wear much clothing. As this excess must be 
taken care of, the cloakrooms in country schools should be propor- 
tionately^ larger than in urban communities. 

The use of halls and walls of classrooms for wraps is objectionable 
because of the untidy appearance. AVlien installed in halls, racks 
are decided obstacles in the case of fire and a distinct menace to life. 

The most suitable location for the cloakroom in schools is yet a 
mooted point. There seems to be no very sound reason why cloak- 
rooms should open into the classroom, as advocated by some authori- 
ties. Furthermore, there is but little to commend the practice advo- 
cated of ventilating the classroom through the cloakroom by an out- 
let placed in the lower part of the communicating door. 

In general, the cloakroom should be easily accessible, with an out- 
side exposure to insure the admission of sunlight and window 
ventilation. It is desirable that cloakrooms should be separately 
ventilated, so that, when the ventilating system is out of order, the 
odors will not pass into the classroom. 



CLOAKROOM ACCOMMODATIONS. 63 

The width usually advised for cloakrooms is about 4 feet, with 
50 linear feet of wall space for each 25 pupils. Suitable pegs or 
hooks should be jDrovided and located on the wall at various levels 
for the accommodation of children of different heights. Racks or 
frames for drying moist clothing are desirable. 

The installation of individual keyless lockers, though not at all 
essential, is an advantage. Lockers of this type are usually of metal, 
and each locker should be ventilated. 

Separate cloakrooms were provided in 38 per cent of the schools 
inspected. Halls and entrance vestibules were used for cloakroom 
purposes in 34 per cent, and the classroom walls in slightly more 
than 25 per cent. In addition, in two schools, a classroom alcove 
was used for cloakroom purposes and in one school the hall was 
used in addition to cloakrooms. 

In numerous instances the cloakrooms inspected were inadequate 
in size, without heat, and presented a neglected appearance. 

JANITOR SERVICE. 

Many of the undesirable aspects of rural school hygiene could be 
directly improved by an efficient janitor service. In large schools 
Avhere janitors are employed, certain definite rules should be made 
with respect to the hours for making fires, the sweeping of claSvS- 
room floors, the dusting of classroom furniture, the removal of 
powdered chalk accumulations, and the routine airing of classrooms 
after school hours. Owing to the ever-present danger of fire, jani- 
tors should be required to remain on the school premises during the 
hours of school to be of assistance in an emergency of this nature. 

Paid janitors were employed in 6 schools of the county. Jani- 
tor's work was performed by the teacher in 58 schools, by the teacher 
and pupils in 4 schools, by the teacher and help paid by herself in 5 
schools, and by the pupils in 2 schools. 



PART n. 



PHYSICAL FITNESS OF RURAL SCHOOL CHILDREN IN 
PORTER COUNTY. 

INTRODUCTORY OBSERVATIONS. 

It is now known that the rate of growth of the human body varies 
in a definite manner. The highest rate is attained during the earlier 
months of embryonic life, from which point it declines until about 
three or four years before puberty. The rate is accelerated during 
adolescence and declines rapidly after mature establishment of the 
reproductive functions. Physiological development, however, pre- 
sents wide individual variations from the normal. 

Definite knowledge of the physical development of the children of 
a county or community is of great value in determining the exist- 
ence of unhealthful influences. The well-known hampering effect 
on growth of hookworm, chronic malaria, and conditions which in- 
duce nutritional diseases is reflected to a great degree over wide areas 
of this country by the stature and rate of growth at different age 
periods of the children of communities so affected. 

The legal limitation of the age at which children may enter cer- 
tain occupations is becoming definitely fixed in an increasing num- 
ber of States. But the intent of these laws will be largely defeated 
unless child labor be restricted to certain occupations according to 
the physical development of a child at a given age period. 

The educator is vitally interested in the physical development 
and perfection of the school child. It enables him to adapt mental 
instruction to physical imperfections in individual cases. 

Because of the wide variations in climate, the influences of immi- 
gration still operating, and the extremes in density of population, no 
uniform standard of physical growth would seem possible in this 
country as a whole. The population is not homogeneous racially, 
and until racial amalgamation shall have been completed the neces- 
sity of determining the mean physical development of children in 
different sections of the country will remain. 

The physical averages of children determined in the past have been 
based largely on an examination of nonrepresentative groups in hos- 
pitals, orphanages, and other institutions. In more recent years, 
however, extensive studies of this nature have been made among 
urban school children. There is need for an extension of these in- 
vestigations to rural communities, where measurements of school 
children of all classes will furnish representative standards. 

64 



INTEODUCTORY OBSERVATIONS. 



65 



Finally, the school building must be considered as a factory, exer- 
cising a marked influence on the physique of children. Indeed, ob- 
servations made in other countries show greater physical develop- 
ment both in height and weight among children attending the better 
class schools. 

NuTnher of children studied. — A total of 2,488 rural school chil- 
dren ^ were studied during this survey. Of these, 1,253 were boys, 
and 1,235 were girls; showing an almost equal distribution of the 
sexes attending school. 

The average daily attendance in these rural schools during the 
school year 1911r-15 was 2,512 (2,264 for elementary schools; 248 for 
high schools). These examinations, therefore, are considered repre- 
sentative of the youthful population of the county. Because of a 
number of attendant circumstances, not every child was examined in 
all the details outlined in this report. The number of individuals 
furnishing data, however, is stated in all statistical tables based on 
physical measurements obtained during this survey. 

Age of school entrants. — The proper age for a child to enter school 
is an educational problem which has not yet been solved satisfac- 
torily. This "is due largely to the relative influence of the personal 
equation of individual children, the home environment, and the 
community school facilities. This problem can not be settled fully 
without due investigation and an analysis of a great number of 
cases bearing on this point. 

School attendance is compulsory in the State of Indiana from 6-14 
years of age, and from 6-16 years of age for those children unable to 
show necessity for engaging in some gainful occupation. 

In Porter County 25 boys and 31 girls were between 5 and 6 years 
of age, and but 86 boys and 111 girls attending the schools were 
over 15 years of age, as shown in the following table : 

Table III. — Age distribution by sex and one-year age periods. 





5 

2.5 
31 


6 


7 


8 


9 


10 


U 


12 


13 


14 


15 


16 


17 


18 


19 


20 


21 


Total 


Boys 


79 

89 


136 
104 


121 
118 


127 
135 


12.5 
127 


110 
115 


125 
128 


116 
109 


112 

91 


74 
67 


49 
50 


20 

28 


7 
17 


6 
5 


2 
1 


2 



1,236 


Girls 


1,215 







In chart 6 is plotted the curve of age distribution for both sexes. 
It is observed that practically one-half the children of either 6ex 
in school attendance were 10 years old and under, and that practically 
8 per cent of the boys and 10 per cent of the girls were 6 years old 
and under, and less than 10 per cent of all the children of either 
sex were over 15 years of age. 

iThe enrollment was: Boys, 1,609; girls, 1,504; total, 3,113. The total number of 
unmarried persons between 6 and 21 in tlie county was 3,935 (males, 2,078 ; females, 
1,857). 

38062°— 16 5 



66 



EURAL SCHOOL SANITATION". 



Per Cent 
O 10 20 30 40 So 6o 7o 8o qo loo 


YRS. 
20 

19 

18 

17 

/6 

IS 

/4 

/3 

/2 

// 

10 

9 

7 
6 

6 






















































































1 
/I 






















,f 






















/ 




















/ 


















y 


/ 


















4 


// 


















A 


/ 


' 


















/ 




















/ 


















*< 


/ 


















ji 




















f< 


A 




















/ 
















' 







SrGN/F/£5 Soys. ^/gnif/e^ Gmts^ 

US.Puauc Health Serv/ce 

Chart 6. — Age distribution by sex for one-year periods of 1,236 boys and 1,215 girls 
attending the rural scliools of Porter County. 



INTRODUCTORY OBSERVATIONS. 67 

According to the calculations of Prof. Thorndyke, 40 per cent 
of the children of New England cities of 25,000 inhabitants or more 
finished the eighth grade. In comparison, the number of children 
who finished the eighth grade in Porter County is small indeed. 
That fcM^er boys than girls from 14 to 17 years of age were attend- 
ing school in this county is due probably to the demands of the 
farm being more insistent than those of domestic occupations. 

PHYSICAL DATA. 

HEIGHT AND WEIGHT. 

Because of circumstances the height and weight of children were 
made in their ordinary clothing and shoes. Due allowance for this 
fact must be made in calculations of the exact weights and heights 
of the children here tabulated. According to the figures of Bow- 
ditch, the clothing of both sexes at 7 years of age weighs 3^ pounds, 
at 10 years of age, 5.7 pounds for boys and 4^ for girls, at 13 years 
of age, 7.4 pounds for boys and 5.6 for girls, and at 16 years of age, 
9.7 pounds for boys and 8.1 pounds for girls. The height to be sub- 
tracted for shoes averages about seven-eighths of an inch. For practi- 
cal purposes, however, these subtractions are unnecessary, because in 
all occupations where physical measurements are liable to be taken 
into consideration these are made with children wearing their or- 
dinary clothing. It may be mentioned, however, that where children 
were wearing more than one coat or jacket these were removed be- 
fore the weights were taken during this survey. 

The rate of growth in both height and weight varies with the 
sex at different age periods.^ Boys attending the rural schools of 
Porter County were taller than girls up to the ninth year, after 
which period the girls were taller than the boys up to the fourteenth 
year; from that age on the boys rapidly grew much taller than the 
girls. 

The greatest rate of annual increase in height in boys was between 
9 and 10 years of age (2.5 inches), 14 and 15 (2.7 inches), and 15 
and 16 (2.5 inches). In girls it may be observed that the rate of 
annual increase was greatest between 9 and 10 years (2.7 inches), 

1 According to the anthropometrical committee of ttie British Association, quoted from 
Parks (Practical Hygiene) : 

Boys are heavier than girls up to 12, but soon after they lose their superiority for 
three years, res^aining it at 16. 

In boys the greatest increase occurs from 14—16 ; in girls from 12—15. 

The rate of growth is irregular or interrupted. Boys are taller than girls up to 12, 
when girls pass them and retain an advantage to nearly 15. 

In boys the greatest annual increases are from 5-6 (almost 3 inches), and from 14-15 
(about 3 inches), namely, at the beginning and the end of elementary school education. 

In girls the greatest annual increase is about 12. 

In girls the annual increase is more uniform than in boys up to 14. 

In girls the growth begins to slow down between 12 and 13, and at 14.5 girls have 
nearly completed their growth, while boys grow rapidly up to 19. 

Girls of 13 and 14 are generally taller and heavier than boys of the same age. 



68 



RURAL SCHOOL SANITATIOlSr. 



and 12 and 13 (2.6 inches), which figures correspond very closely 
to those quoted above. 

From 16 to 17 years of age there is a remarkable decline in the 
annual rate of increase in height of both boys and girls, corresponding 
to the maturation of the sexual functions in cold climates. The rate 
remains low in the case of girls, but continues high for boys during 
the two following years. It will be observed further on in this re- 
port that this decline is noticeable in all of the physical measurements 
recorded, but more noticeable in the case of girls. 

Boys were heavier than the girls up to 9 years, and the girls were 
heavier than the boys from the ninth to the fifteenth year, at which 
period the weight of the girls declines quickly to rise again slowly. 
From 15 years of age on, the boys rapidly grow much heavier than 
the girls. 

The greatest annual increase of weight in boys was between 15 and 
16 years of age (14.8 pounds), the rate also being high between 14 
and 15 years of age (10.3 pounds). 

The greatest increase in weight of girls was between 14 and 15 
years of age, followed by ^ decided decline between 15 and 16. The 
annual increase in weight of girls continued small from the six- 
teenth year on. 

The decline in the annual rate of increase in weight of boys is not 
so decided as in the case of girls and occurs one year later, corre- 
sponding to a similar decline in the height rate. 

MEAN HEIGHT AND WEIGHT. 

A comparison of the • mean height and weight of the Porter 
County school children to that of the children of other localities is 
shown in the following table : 



Table IV. — Mean height and weight of rural school children, Porter County, 
Ind., with comparative tables of height and weight, for one-year age periods. 






Porter Comity, Ind. 


Landois. 


Boas. 


Age period 


Male. 


Female. 


Male. 


Female. 


Male. 


Female. 




Height 
In inches. 


Height 
in centi- 
meters. 


Height 
in inches. 


Height 
in centi- 
meters. 


Height 
in centi- 
meters. 


Height 
in centi- 
meters. 


Height 
in inches. 


Height 
ia mches. 


Years. 
5-6 


46.73 
47.17 
48.73 
49.61 
52.08 
54.09 
55.50 
57.51 
58.70 
61.40 
63.93 
64.52 
66.67 
68.96 


118.6 
119.8 
123.7 
126.0 
132.2 
137.3 
140.9 
146.0 
149.0 
155.9 
159.7 
163.8 
166.7 
175.1 


44.74 
46.66 
47.98 
49.67 
52.35 
53.96 
55.67 
58.27 
60.06 
61.83 
62.63 
63.01 
63.63 
63.57 


113.6 
118.2 
121.8 
126.1 
132.9 
137.0 
141.1 
148.0 
152.5 
156.9 
159.0 
159.5 
161.5 
161.4 


99.0 
104.6 
111.2 
117.0 
122.7 
128.2 
132.7 
135.9 
140.3 
148.7 
153.9 
161.0 
167.0 
176.0 


97.0 
103.2 
109.6 
113.9 
120.0 
124.8 
127.5 
132.7 
138.6 
144.7 
147.5 
150.0 
154.4 
156.2 


41.7 
43.9 
46.0 
48.8 
50.0 
51.9 
53.6 
65.4 
67.5 
60.0 
62.9 
64.9 
66.5 
67.4 


41.3 


6-7 


43.3 


7-8 .. 


45.7 


8-9 


47.7 


9-10 


49.7 


10-11 


51.7 


11-12 


53.8 


12-13 


66.1 


13-14 


68.5 


14^15 


60.4 


15-16 


61.6 


16-17 


62.0 


17-18 


62.7 


18-19 









PHYSICAL DATA. 



69 



Table IY. — Mean height and ireight of rural sehool children, Porter County, 

Ind., etc. — Continued. 





Porter County, Ind. 


Landois. 


Burke. 


Age period. 


Male. 


Female. 


Male. 


Female. 


Male. 


Female. 




Weight in 
pounds. 


Weight in 
kilos. 


Weight in 
pounds. 


Weight in 
kilos. 


Weight in 
kilos. 


Weight in 
kilos. 


Weight in 
pounds. 


Weight in 
pounds. 


Years. 
5-6 


49.68 
51.75 
54.72 
60.21 
64.56 
71.75 
73.30 
84.00 
92.48 
102. 74 
117. 56 
121.95 
134.05 
140.00 


22.50 
23.25 
24.75 
27.35 
29.25 
32.60 
33.25 
38.00 
42.00 
46.75 
53.50 
55.45 
61.00 
63.75 


45.31 
48. 68 
51.60 
57. 60 
64.36 
70.03 
79.07 
SO. 78 
95.20 
105. 90 
105.38 
, 113.98 
120.75 
117.23 


20.50 
22. 10 
23. 40 
20. 30 
29.15 
31.80 
36.05 
39. 50 
43.25 
48. 20 
47.75 
51.75 
54.77 
53.40 


16.70 
18.04 
20.16 
22.26 
24.09 
26.12 
27.85 
31.00 
35.32 
48.50 
46.41 
53.39 
57.40 
61. 26 


15.50 
16.74 
18.45 
19.82 
22.44 
24.24 
20. 25 
30.54 
34.65 
38. 10 
41.30 
44.44 
49.08 
53.10 






6-7 


45.2 
49.5 
54.5 
59. 6 
65.4 
70.7 
76.9 
84.8 
95.2 
107.4 
121.0 


43.4 


7-8 


47.7 


8-9... 


52.5 


9-10 


57.4 


10-11 

11-12 


62.9 
69.5 


12-13 

13-14 


78.7 
88.7 


14-15 

15-16 


98.3 
106.7 


16-17 

17-18 


112.3 
115.4 


18-19 




114.9 











Porter County, Ind. 


Comparative table (Boas). 


Age period. 


Absolute annual 
increase in 
height in inches. 


Per cent absolute 
annual increase 
in height. 


Absolute annual 
increase in 
height in inches. 


Per cent absolute 
annual increase 
in height. 




Male. 


Female. 


Male. 


Female. 


Male. 


Female. 


Male. 


Female. 


Years. 
6-7 


0.44 
1.56 

.88 
2.5 
2.0 
1.4 
2.0 
1.2 
2.7 
2.5 

.6 
2.2 
2.3 


1.9 

1.3 

1.7 

2.7 

1.6 

1.7 

2.6 

1.8 

1.8 

1.8 

.8 

.4 

.6 


0.9 
3.3 
1.8 
4.9 
3.8 
2.1 
3.6 
2.0 
4.6 
4.1 
.9 
3.4 
3.4 


4.2 

2.7 
3.5 
5.4 
3.0 
3.1 
4.6 
3.1 
3.0 
1.3 
.6 
.9 


2.2 
2.1 
2.8 
1.2 
1.9 
1.7 
1.8 
2.1 
2.5 
2.9 
2.0 
1.6 
.9 


2.0 
2.4 
2.0 
2.0 
2.0 
2.1 
2.3 
2.4 
1.9 
1.2 
.6 
.5 


5.3 

4.8 
6.1 
2.5 
3.8 
3.3 
3.4 
3.8 
4.3 
4.8 
3.2 
2.5 
1.4 


4 8 


7-8 


6 5 


8-9 


4 4 


9-10 


4 2 


10-11 


4 


11-12 


4 1 


12-13 


4 3 


13-14 


4 3 


14-15 


3 2 


15-16 


2 


16-17 


1 


17-18 


g 


18-19 














Porter County, Ind. 


Comparative table (Burke). 


Age period. 


Absolute annual 
increase in 
weight, pounds. 


Per cent absolute 
annual increase 
in weight. 


Absolute annual 
increase in 
weight in 
pounds. 


Per cent absolute 
annual increase 
in weight. 




Male. 


Female. 


Male. 


Female. 


Male. 


Female. 


Male. 


Female. 


Years. 
6-7 


1.5 

3.6 

5.5 

4.4 

7.2 

1.6 

10.7 

8.5 

10.3 

14.8 

14.4 

12.1 

6.0 


3.4 
2.9 

6.0 
6.7 
5.7 
9.0 
7.7 
8.3 
10.7 
-.5 
8.6 
6.8 
-1.4 


3.0 

7.0 
10.1 

7.3 
11.1 

2.2 
14.1 
10.1 
11.1 
14.4 
12.2 
10.0 

4.0 


7.5 

5.9 

11.6 

11.6 

8.9 

12.8 

9.7 

9.5 

11.3 

-.4 

8.2 

5.9 

-1.1 










7-8 


4.3 
5.0 
5.1 
5.8 
5.3 
6.2 
7.9 
10.4 
12.2 
13.6 


4.3 
4.8 
4.9 
5.5 
6.6 
9.2 
10.6 
9.6 
8.4 
5.6 
3.1 


9.5 
10.1 
9.3 
9.7 
8.1 
8.7 
10.3 
12.3 
12.8 
12.7 


9.9 
10.0 
9.3 
9.6 
10.5 
13.2 
12.7 
11.9 
8.5 
5.2 
2 8 


8-9 


9-10 . 


10-11 


11-12 


12-13 


13-14 


14-15 


15-16 


16-17 


17-18 


18-19 

















70 



EUEAL SCHOOL SAISTITATION". 



Table IV. — Mean height and tveight of rural school children, Porter County, 

Ind., etc. — Continued. 





Relation of annual increase in height of 
Porter County children to the com- 
parative (Boas). 


Relation of annual increase in weight of 
Porter County children to the com- 
parative (Burke). 


Age period. 


Absolute in inches. 


Per cent. 


Absolute in pounds. 


Per cent. 




Male. 


Female. 


Male. 


Female. 


Male. 


Female. 


Male. 


Female. 


Years. 
6-7 


-1.8 

- .5 
-2.0 
+1.3 
+ .1 

- .3 
+ .2 

- .9 

±:i 

-1.4 
+ .6 


-0.1 
-1.1 

- .3 

- .3 

- .4 

- .4 
+ .3 

- .6 

- .1 
+ .6 
+ .2 

- .1 


-4.4 
-1.5 
-4.3 
+2.4 
.0 
-1.1 
+ .2 
-1.8 
+ .3 
- .7 
-2.3 
+ .9 


-0.6 
-2.8 

- .9 
+ 1.2 
-1.0 
-1.0 
+ .3 
-1.2 

- .2 

- .7 

- .4 
+ .1 










7-8 


-0.7 
+ .5 

- .7 
+1.4 
-3.7 
+4.5 
+ .6 

- .1 
+ 2.G 
+ .8 


-1.4 
+1.2 
+1.8 
+ .2 
+2.4 
-1.5 
-2.3 
+ .9 
-8.9 
+3.0 
+3.7 


-2.5 

.0 

-2.0 

+1.4 
-5.9 
+5.4 

- .2 
-1.2 
+ 1.6 

- .5 


—3.6 


8-9 

9-10 


+1.6 
+2.3 


lO-ll 


— .7 


11-12 

12-13 


+2.3 
-3.5 


13-14 


-3.2 


14-15 .. 


— .6 


15-16 


—8.9 


16-17 


+3.0 


17-18 













It may be observed that the mean height of boys of Porter County 
is less at the 6-7, 7-8, 8-9, 11-12, 13-14, 15-16, and 16-17 age periods. 
The girls in comparison are under the mean height at 12-13, 15-16 
and 16-17 year age periods. The per cent of deficiency ranges from 
0.7 per cent to 2.3 per cent among the boys and 0.2 per cent to 2.8 
per cent among the girls. 

With regard to weight, the boys are under the mean at the 7-8, 
9-10, 10-12, and 14^15 year age periods. The girls are under the 
mean weight at the 7-8, 12-13, 13-14, and 15-16 year age periods. 
The per cent of weight deficiency varies from 0.2 per cent to 5.9 per 
cent among boys and 0.6 per cent to 8.9 per cent among the girls. 



RACIAL DIFFERENCES IN PHYSICAL DEVELOPMENT. 

In Table V is given the statistical tabulation of the mean physical 
measurements of 2,488 school children of the county compared to 
similar mean measurements of 364 boys and 377 girls of the county 
who were either foreign born or of parents one or both of whom 
were of foreign birth : 



PHYSICAL DATA. 



71 



Table V. — Mean physical measurements of all children attending the rural 
schools of Porter County, Ind., 1914-15, compared with those of 364 boys and 
377 girls who are foreign born or have one or both parents foreign born. 

[Classified by race, sex, and 1-year age periods.] 





Males. 


Race. 


Age 
period. 


Cases 
fur- 
nish- 
ing 
data. 


Mean 
height. 


Mean 
weight. 


Vital 
capac- 
ity. 


Chest 
expan- 
sion. 


Dynamom- 
eter. 


Cephalic index. 




Right. 


Left. 


Doli- 
choce- 
phalic. 


Mesati- 

ce- 
phalic. 


Brachy- 

ce- 
phalic. 




Yrs. 

5-6 

6-7 
6-7 
6-7 
6-7 
6-7 

.7-8 

7-8 
7-8 
7-8 
7-8 

8-9 
8-9 
8-9 
8-9 
8-9 

9-10 
9-10 
9-10 
9-10 
9-10 
9-10 

10-11 
10-11 
10-11 
10-11 
10-11 
10-11 
10-11 

11-12 
11-12 
11-12 
11-12 
11-12 
11-12 

12-13 
12-13 
12-13 
12-13 
12-13 
12-13 

13-14 
13-14 
13-14 
13-14 
13-14 
13-14 
13-14 

14-15 
14-15 
14-15 
14-15 
14-15 
14-15 


25 
1 

78 
1 
7 
6 
7 

139 

3 
9 
10 
13 

123 
3 

14 
6 

11 

131 

1 

i 
11 

14 

124 

1 
5 
15 
1 

10 
12 

110 
1 
2 

16 
8 

12 

123 
1 
2 
15 
12 
12 

116 

1 
3 
1 

13 
5 

11 

112 
1 
2 

15 
6 

14 


Inches . 
46.73 
47.00 

47.17 
46.00 
48.50 
46.37 
47.50 

48.73 

47.91 
49.50 
47.77 
49.23 

49.61 
50.75 
57.10 
50.54 
49.11 

52.08 
51.50 
52. 25 
50.48 
52.29 
52.08 

54.00 
54.00 
53.54 
55.95 
51.00 
56.15 
52.74 

55.50 
50.25 
54.00 
66.48 
52.12 
55.45 

57.51 
57.75 
57.25 
56.16 
58.21 
60.08 

58^70 
60.25 
58.91 
61.00 
60.60 
59.70 
58.50 

61.41 
54.25 
64.12 
61.33 
58.25 
61.50 


Lbs. 

49.68 

49.00 

51.15 
57.00 
53.42 
57.50 
61.00 

54.42 

53.33 

58.22 
53.10 
55.00 

60.21 
55.66 
57.57 
60.00 
59.63 

64.56 
67.00 
67.50 
64.07 
65.63 
63.07 

71.75 
68.00 
67.60 
81.86 
65. 00 
72.77 
69.25 

75.30 
85.00 
63.50 
78.75 
66.62 
78.66 

84.00 
87.00 
85.00 
78.86 
88.12 
84.08 

92.48 
101.00 
114.00 

90.00 
100.15 

99.40 

93.45 

102. 74 
67.00 
117.00 
109. 13 
103.00 
103. 35 


Cu. in. 


Inches . 


Kilos. 


Kilos. 


Per ct. 
52.20 

46.00 
100.00 
57.10 

"85." 76' 

34.00 

33.33 
11.10 
10.00 
26.00 

33.75 
33.33 
14.25 
33.33 
45.48 

37.00 
100.00 
50.00 
23.10 
9.10 
61.55 

40.60 
100.00 
80.00 
46.65 

'"58." 25' 
39.25 

""25." 66" 
"4i.'e6' 

37.35 
100.00 
100.00 
42.85 
14.30 
75.00 

36.00 


Per ct. 
34.80 
100.00 

31.00 


Per ct. 
13 00 


Scandinavians 


35.00 


1.75 


5.00 


5.00 


23.00 


Dutch 


45.66 
36.15 
50.00 
48.23 

46.62 

35.00 
52.75 
37.55 
48.00 

61.72 
67.65 
65.35 
61.65 
60.00 

71.71 
60.00 
67.60 
70.35 
65.90 
72.50 

87.01 
100.00 
65.00 
106. 35 
55.00 
92.00 
75.00 

93.72 
145.00 
75.00 
96.25 
66.60 
91.25 

110.25 
135.00 
127.00 
104. 65 
125.00 
104.85 

127. 46 
165.00 
118.35 
100.00 
138.20 
141.00 
136. 50 

147. 34 
90.00 
160. 00 
157. 35 
131.00 
160.00 


1.60 
2.08 
2.25 
1.80 

2.00 

2.35 
1.90 
1.95 
2.00 

2.21 
3.00 
2.10 
2.05 
2.15 

2.43 
2.00 
2.50 
2.40 
2.55 
2.40 

2.59 
3.00 
3.00 
2.65 
2.00 
2.65 
2,45 

2.29 
3.00 
2.10 
2.56 
2.45 
2.40 

2.89 
3.00 
3.25 
2.50 
2.55 
2.75 

2.85 
2.50 
2.50 
3.50 
3.60 
2.70 
2.75 

2.87 
3.00 
3.50 

"2.46' 
2.95 


8.00 
8.7 
8.3 
8.0 

9.2 

8.7 
10.5 
9.6 
9.1 

11.2 
10.0 
11.6 
12.7 
10.9 

11.7 
15.0 


8.00 
8.7 
6.3 
6.2 

8.4 

10.6 
9.4 
9.2 
6.6 

10.1 
11.5 
10.3 
11.3 
10.0 

11.3 
11.5 




German 


42.90 
15.75 
14.30 

43.75 

66.66 
77.80 
20.00 
75.00 

41.25 
33.33 
71.50 
16.67 
36.35 

48.75 




Polish 


84.25 


Scandinavian 

All races 

English, Scotch, 
Irish 


22.25 


German, etc 

Polish, etc 


11.10 
20.00 


Scandmavian 

All races 


26.00 


English 


33.33 


German 


14 25 


Polish 


50 00 


Scandinavian 

All races 


18.10 
14.25 


Dutch 




English 


"38." 45' 
27.25 
30.75 

44.50 


50 00 


German 


13.4 
13.6 
11.0 

14.3 
11.5 
13.4 
16.2 
8.0 
14.6 
14.7 

15.0 
16.9 
12.4 
17.6 
12.7 
15.9 

17.3 
18.5 
18.5 
16.9 
18.5 
18.4 

19.6 
20.3 
20.3 
25.5 
22.3 
20.3 
20.4 

24.0 
15.0 
24.8 
23.8 
23.1 
25.2 


12.3 
12.0 
9.7 

13.4 
11.5 
14.4 
16.4 
8.0 
12.8 
14.5 

13.6 
18.5 
11.5 
15.1 
11.8 
15.0 

16.5 
20.3 
17.8 
15.7 
16.1 
16.2 

17.0 
16.9 
17.8 
18.5 
19.8 
18.9 
19.3 

21.9 
15.0 
24.8 
23.0 
21.9 
24.2 


38.45 


Polish 


63.65 


Scandinavian 

All races 

Dutch 


7.70 
15.00 


English 

German 


20.00 
40.00 
100.00 
60.00 
41.75 

43.50 
100. 00 
100.00 
37.50 
25.00 
50.00 

47.20 


13 35 


Italian 




Polish 


40 00 


Scandinavian 

All races 


17.25 


Dutch 




EngUsh, etc 

German 


"'3706 


Polish 


75 50 


Scandinavian 

All races . 


8.40 
15 45 


Dutch 




English 








42.86 
57.16 
16.65 

46.00 


14.30 

28 55 


Polish . 


Scandinavian 

All races 


8.35 
18 00 


Dutch 


100 00 


English 


66.66 


33.33 




French 






28.55 

"56.' 66' 

42.66 
100.00 
100.00 
43.00 
16.66 
46.25 


67.16 
76.00 
40.00 

41.10 


14.30 
25.00 
10.00 

15.75 


Polish 


Scandinavian 

All races 


Austrian 


English 






German . . 


57.00 
60.00 
38.45 




Polish 


33.35 
15.30 


Scandinavian 



72 



ETJEAL SCHOOL SANITATION. 



Table V. — Mean physical measurements of all children attending the rural 
schools of Porter County, Ind., 1914-15, etc. — Continued. 



Bace. 



Males. 



period, 



Cases 
fur- 
nish- 
ing, 
data. 



Mean 
height. 



Mean 
weight. 



Vital 
capac- 
ity. 



Chest 
expan- 
sion. 



Dynamom- 
eter. 



Right. 



Left. 



Cephalic index. 



Doli- 
choce- 
phalic. 



Mesati- 

ce- 
phalic. 



Brachy- 

ce- 
phalic. 



All races 

Austrian 

English 

German 

Polish 

Roumanian . . 
Scandinaviaii. 

All races 

English 

German 

Scandinavian. 



Yrs. 
15-16 
15-16 
15-16 
15-16 
15-16 
15-16 
15-16 

16-17 
16-17 
16-17 
16-17 



Inches. 
63.93 
62.50 
64.87 
65.50 
60.23 
53.50 
64.50 

64.52 
64.50 
66.50 
64.07 



Lis. 
117.56 
127.00 
123. 00 
111.77 
113.00 
130. 00 
122. 35 

121.95 
113.35 
125. 00 
115. 85 



Cu. in. 
180. 42 
175.00 
160.00 
163. 35 
113. 00 
260. 00 
197. 50 

188. 75 
175.00 
185. 00 
172. 15 



Inches. 
3.11 
2.25 
3.60 
3.00 
2.35 
3.50 
3.85 

3.29 
4.50 
3.50 
3.20 



Kilos. 
28.6 
29.0 
23.8 
25.0 
21.5 
30.8 
31.7 

30.2 
30.8 
20.3 
30.0 



Kilos. 
27.9 
29.0 
21.3 
25.0 
22.4 
35.5 
29.0 

26.8 

28.5 
18.5 
27.0 



Per ct. 
35.10 



Per ct. 
43.25 



100. 00 
42.50 



57.50 
40.00 



38.35 
33.33 



33.33 

51.00 

66.66 

100. 00 

14.30 



Per ct. 
21.05 
100. 00 



60.00 
100. 00 



10.65 



Race. 



Females. 



Age 
period 



Cases 
fur- 
nish- 
ing 

data. 



Mean 
height 



Mean 
weight. 



Vital 

capac- 
ity. 



Chest 
expan- 



Dynamom- 
eter. 



Right. 



Left. 



Cephalic index. 



Doli- 
choce- 
phalic. 



Mesati- 

ce- 
phalic. 



Brachy- 

ce- 
phalic. 



All races. 
English.. 
German . , 



All races 

English 

German 

Italian 

Polish 

Scandinavian. 



All races 

English 

German 

Italian 

Polish 

Scandinavian. 



All races 

English 

German 

Polish 

Scandinavian. 



All races 

English 

German 

Polish 

Roumanian . . . 
Scandinavian . 



All races 

Austrian 

English 

French 

German 

Polish 

Scandinavian. 



Yrs. 
5-6 
5-6 
5-6 

6-7 
6-7 
6-7 
6-7 
6-7 
6-7 

7-8 
7-8 
7-8 
7-8 
7-8 
7-8 

8-9 
8-9 
8-9 
8-9 
8-9 

9-10 
9-10 
9-10 
9-10 
9-10 
9-10 

10-11 
10-11 
10-11 
10-11 
10-11 
10-11 
10-11 



105 

3 

10 

1 

3 



120 
3 
17 
10 
9 

133 
1 

12 
9 
1 

10 

129 
1 
1 
1 

13 
9 

17 



Inches. 
44.74 
41. 50 
45.37 

46.66 
45.75 
49.85 
46.00 
47.00 
46.00 

47.98 
48.41 
48.60 
46.50 
48.25 
48.75 

49.67 
49.58 
43.85 
50.20 
50.15 

52.35 
49.20 
53.15 
53.75 
54.00 
51.40 

53.96 
55.00 
52.25 
57.75 
54.55 
52.70 
54,20 



Lbs. 
45.31 
40.00 
49.00 

48.68 
45.00 
48.55 
50.00 
49.50 
46.65 

51.60 
52.65 
52.60 
52.00 
50.35 
53.44 

57.66 
55. 00 
57.75 
61.10 
58.90 

64.36 
56.00 
71.60 
61.20 
74.00 
59.00 

70.03 
54.00 
54.00 
82.00 
75.70 
65.10 
7L65 



Cu. in. 



Inches . 



Kilos. 



17.50 
38. 35 
20.00 
36.65 
26.25 

37.45 
41.65 
41.50 
35.00 
26.65 
41.65 

48.31 
48.35 
47.50 
38.00 
56.65 

58.73 
55.00 
59.50 
50.00 
90.00 
56.65 

69.81 
35.00 
65.00 
100.00 
73.85 
61.10 
72.50 



L35 
2.00 

2.05 
2.00 
1.60 
1.50 
2.00 
1.90 

1.94 
L50 
1.85 
1.60 
2.15 

2.17 
2.50 
2.20 
1.85 
2.00 
1.80 

2.49 
2.75 
3.00 
3.00 
2.65 
2.00 
2.40 



3.00 
3.00 



3.00 
3.00 



8.00 
8.00 



8.00 
6.1 



8.00 
5.00 



8.0 



8.00 
5.00 



6.2 



10.0 
8.0 
5.0 

1L6 



8.0 
9.2 
9.0 
8.2 

10.5 
10.0 
11.4 
10.4 
11.5 
9.1 

11.4 
10.0 
13.4 
15.0 
14.0 
11.2 
11.2 



9.6 
8.0 
5.0 
11.5 

8.0 
8.0 
8.4 
7.5 
8.2 

9.6 

8.0 
10.5 

9.4 
11.5 

7.4 

10.4 
10.0 
11.5 
11.5 
12.8 
10.4 
10.4 



Per ct. 

44.85 
100. 00 

50.00 



46.15 
100. 00 
42.85 
100.00 
25.00 
50.00 

35.20 
33.33 
20.00 



55.65 

42.75 
66.66 
25.00 
20.00 
44.45 

44.15 



45.45 
22.20 



88.90 
40.50 



100. 00 
46.20 
11.10 
56.20 



Per ct. 
31.00 



56.25 
50. 00 
22.20 

42.25 



54.55 
33.35 
100. 00 
11.10 

43.00 
100.00 



38. 45 
44.45 
37.55 



Per ct. 
24.50 



50.00 




35.85 


18.00 


42.85 


14.30 


"so." 66" 


75.00 


52.35 
66.66 
40.00 
100.00 
100. 00 
33.35 


1L45 
""46."66 

""'ii.'io 


45.30 
33.33 


11.95 



18.75 
30.00 
33.35 

13.30 

'44.'45 



16.50 



15.35 

44.45 
6.25 



PHYSICAL DATA. 



73 



Table V. — Mean physical measurements of all children attending the 7-ural 
schools of Porter County, Ind., 1914-15, etc. — Continued. 















Females. 










Race. 


Age 
period. 


Cases 
fur- 
nish- 
ing 
data. 


Mean 
height. 


Mean 
weight. 


Vital 
capac- 
ity. 


Chest 
expan- 
sion. 


Dynamom- 
eter. 


Cephalic index. 




Right. 


Left. 


Doli- 
choce- 
phalic. 


Mesati- 

ce- 
phalic. 


Brachy- 

ce- 
phalic. 




Yrs. 
11-12 
11-12 
11-12 
11-12 
n-12 
11-12 

12-13 
12-13 
12-13 
12-13 
12-13 

13-14 
13-14 
13-14 
13-14 
13-14 

14-15 

14-15 
14-15 
14-15 
14-15 

15-16 
15-16 
15-16 
15-16 
15-16 

16-17 
16-17 
16-17 
16-17 
16-17 


114 

1 
1 

13 
7 

18 

128 
4 

16 
7 

10 

109 
2 

20 
8 

12 

91 

6 
10 
9 

18 

67 
4 

10 
1 

8 

50 
1 
3 

1 
1 


Inches. 
55.67 
54.25 
55.50 
56.15 
53.75 
56.65 

58.27 
56.95 
59.15 
56.90 
58.65 

60.06 
59.00 
60.21 
58.56 
59.35 

61.83 

60.70 
60.97 
61.61 
60.00 

62.63 
62.06 
63.52 
59.00 
64.53 

63.01 
61.25 
63.41 
63.75 
63.25 


Lbs. 

79.07 

41.00 

85.00 

77.40 

65.30 

76.95 

86.78 
77.75 
91.60 
75.85 
93.10 

95.20 
78.00 
98.55 
86. 25 
89.75 

105.90 

99.33 
100. 30 
109. 77 
102. .50 

105. 38 
94.50 

111.42 
87.00 

113.12 

113. 98 
116.00 
106. 33 
118.00 
114.00 


Cu. in. 
83.38 

100.00 
70.00 
87.70 
50.70 
78.60 

87.54 
68.35 
86.25 
76.15 
97.00 

96.57 
67.50 

102.00 
71.25 

100.40 

110.00 

117.50 
106. 50 
95. 00 
98.60 

114.32 
102. 50 
104. 50 
65.00 
126. 25 

119.37 
110.00 
136. 65 
110.00 
175.00 


Indies. 
2.51 
2.75 
2.50 
2.50 
2.00 
2.45 

2.68 
2.25 
2.60 
2.55 
2.70 

2.78 
2.60 
2.70 
2.40 
2.75 

2.77 

2.25 
2.50 
2.95 
2.60 

3.00 
2.60 
2.90 
2.50 
3.30 

3.00 
3.25 
3.25 
2.50 
3.50 


Kilos. 
13.7 
18.5 
11.5 
13.3 
11.6 
13.3 

15.0 
13.4 
15.6 
14.7 
17.5 

17.6 
1.3.4 
17.7 
16.9 
17.3 

20.2 

17.5 
21.0 
21.2 

18.4 

20.1 
18.5 
20.5 
18.5 
22.9 

21.0 
30.8 
22.0 
20.3 
25.5 


Kilos. 
12.2 
16.9 
10.0 
11.4 
11.3 
12.3 

12.7 
14.0 
14.4 
13.9 
14.6 

15.6 
14.4 
16.5 
14.6 
16.2 

16.1 

13.7 
17.8 
18.5 
20.3 

17.9 
18.0 
17.4 
15.0 
19.7 

18.8 
25.5 
IS. 5 
18.5 
25.5 


Perct. 
36.50 


Per ct. 
51.00 
100.00 


Perct. 
12. 50 


Belgian 




English 






27.40 

"si." 25' 

43.00 
75.00 
68. 75 
50.00 
60.00 

37.20 
100. 00 
40.00 
16. 65 
75.00 

49.40 

20.00 
20.00 

' '68.' 25' 

51.40 
100.00 
40.00 

60.00 


54.40 
71.45 
25.00 

44.10 
25.00 
31.25 
35. 33 
40.00 

48.30 


18. 20 


Polish 


28.55 


Scandinavian 

All races 


43.75 
12.40 


English 




German 




Polish 


16.66 


Scandinavian 


14.50 


English 




German 


50.00 
16. 65 
12.50 

50.00 

80.00 
60.00 

85.75 
28.55 

45.75 


10.00 


Polish 


66.70 


Scandinavian 

All races 


12.50 
10.60 


English, Scotch, 




German 

Polish 


20.00 
14.25 


Scandinavian 

AU races 


7.20 
2.85 


English 




German 


40.00 
100.00 
100.00 

28.00 


20.00 


Polish . 




Scandinavian 

All races . 


12 00 


Belgian 




German 


100.00 






Polish 


100.00 




Scandinavian 













In general, the mean height and weight of children of German, 
Polish, and Scandinavian origin were greater than the corresponding 
heights and weights for the county as a whole. Of these, boys of 
German origin were tallest at the 6-7, 7-8, 8-9, 11-12, 13-14, 15-16, 
and 16-17 year age periods, the Polish at the 9-10 and 10-11 year age 
periods, and Scandinavian at the 12-13 and 14-15 year age periods. 
In weight, the boys of German origin were heavier at the 8-9, 10-11, 
11-12, 14^15, and 16-17 year age periods, boys of Polish origin at 
the 6-7 and 13-14 year age periods, and boys of Scandinavian origin 
at the 7-8, 9-10, and 15-16 year age periods. 

In the case of girls, those of German origin were the tallest at the 
6-7, 10-11, 12-13, and 13-14 year age periods, Scandinavian at the 
7-8, 11-12, and 15-16 year age periods, and the Polish girls at the 
8-9. 9-10, 14-15, and 16-17 year age periods. 



74 RUEAL SCHOOL SAISTITATION. 

With regard to weight, the girls of Polish extraction were the 
heaviest at the 6-7, 8-9, 14r-15, and 16-17 year age groups, and the 
German at the 9-10, 11-12, and 13-14 year age periods. 

The number of units in each of these nationality groups was too 
small to give more than approximate results. In the cases quoted, 
however, the collected data are sufficient to warrant the statement 
that the mean height and weight for the county at large has not 
been reduced by the admixture of these elements. 

VITAL CAPACITY. 

The mean vital capacity was determined in the case of 1,122 boys 
and 1,079 girls, using the dry spirometer for this purpose. Detach- 
able glass mouthpieces were made use of, a special mouthpiece being 
furnished each child which was sterilized in every case before it 
was used again. 

Vital capacity is influenced by a number of factors. Of these 
may be mentioned stature, body weight, age, sex, and occupation. 
It increases with age, attaining the maximum at about the thirty- 
fifth year; it is greater for men than for women, the average for 
the former being about 3,700 cubic centimeters and for women 2,500 
cubic centimeters. The vital capacity is also influenced by posture 
and the condition of the stomach, being greater in the standing posi- 
tion and when the stomach is empty. 

The mean vital capacity of the rural school children of Porter 
County is plotted in chart 7, showing interesting differences between 
the sexes. The rise of lung capacity is constant in boys from the 
seventh to the eighteenth year, the curve showing a decided break 
between the fifteenth and sixteenth years, corresponding to the de- 
cline in rate of increase of other physical measurements observed at 
this age period. 

In the case of girls, however, the increase in vital capacity is 
similar to that for boys up to the eleventh year, the only difference 
being the lesser capacity influenced by sex. At this period of life the 
outdoor activities of girls are very much the same as those of boys 
of the same age. From this time on girls begin to wear corsets, 
though their outdoor activity may continue for a period. The effect 
of these changes is reflected probably by the vital capacity curve 
which falls away from that for the boys and continues to decline 
gradually to the fourteenth year. After the fourteenth year, the 
average girl becomes more sedate, her outdoor activities are lessened, 
and she undergoes certain functional disturbances which are re- 
flected by an obvious decline in the vital capacity increase. This con- 
tinues to the seventeenth year, after which there is a still more 
decided fall. 



PHYSICAL DATA. 



75 




diGNIFIES BOY-5 



Signifies G/rls. 



1/5. Public Health Service 

Chart 7. — Mean vital capacity in cubic inches of 1,122 boys and 1,079 girls from 7 to 18 
years of age attending Porter County rural schools. 



76 



RURAL SCHOOL SANITATION". 



CHEST EXPANSION. 



Measurements of the mean chest expansions were made in the case 
of 1,122 boys and 1,079 girls (see chart 8). The chest expansion for 
boys rose gradually from less than 1 inch at the sixth year to nearly 




5IGNIFIE5 BoYS>. === Signifies Girls,. 

U.5. Public Health Service 

Chart 8. — Chest expansion in inclies of 1,046 boys and 1,029 girls from 6 to 18 years of 
age attending the rural schools of Porter County. 

4 inches at the eighteenth year. In the case of girls the rise was 
likewise gradual from less than 1 inch at the sixth year to a 
maximum of about 3 inches at the fifteenth year. It remained prac- 
tically stationary for girls from 15 to 16 and declined sharply be- 
tween 17 and 18. 

DYNAMOMETER TESTS. 

The muscular strength of the hands cf boys increased constantly 
from the seventh to the eighteenth year. A slight decline in the 
rate took place between the fifteenth and sixteenth year. In girls, 
the rate of increase was also fairly constant and remained stationary 
between the fifteenth and sixteenth year, corresponding in this re- 
spect to other physical measurements of girls at this age period (see 
chart 9, page 77) . 

There were recorded 25 cases of left-handedness, 19 among the boys 
and 6 among the girls. 

CEPHALIC INDEX. 

The size and shape of the head is determined largely by environ- 
ment, sex, and race. The ethnical significance of these cephalic 
measurements is great when employed in communities having 
racially mixed populations to determine the extent of amalgama- 
tion of races and to explain certain habits, customs, and trends of 
mind. 



PHYSICAL DATA. 



77 



Kilos 
30 

2o 

10 




7to8 

YRS. 


8to9 

YRS. 


9toI0 

YRS. 


IOtoII 

YRS. 


1]T0?2 
YRS. 


I2to]3 

YRS. 


13 TO 14 
YRS. 


I4toI5 
YRS. 


|5to16 

YRS. 


I6tdI7 

YR5. 


\7toI8 
YRS. 


































































/ 




















y 


f 


















/*•*. 


X 

• 


• 
/ 
















/ 


1 


-./ 


















// 






.© 














/ 


/ 


• ••&''' 


• '^ 














y 




' . 


r'^^^ 


,jrs*'^- 


-■^,. 










^^ 




-••r* 
'^.^"" 


^''' 


f^ 










/ 


^ 


^-^^z 

T-^"" 




;>' 












/r^ 




• V 


.^'*^' 


















^x-'"" 


















^^' 


»^ 

































































3iCNiF/£5 Right Hand ofBoys. Signified RightHandof Qua. 

" L^FT " •• " . rs«;^-= /. L£Fr - - - , 

^.^. Public HealthServicc. 

Chart 9. — Average muscular strength of the hands of 987 boys and 920 girls attending 
Porter County rural schools. 



78 BUEAL SCHOOL SANITATION. 

The shape of the head has been tabulated in Table V in the case 
of 1,195 boys and 1,055 girls and classified according to sex and 
one-year age periods. Of the boys, 38.15 per cent were dolichocephalic, 
44 per cent mesaticephalic, and 17.85 per cent brachycephalic. Of 
the girls, 41.8 per cent were dolichocephalic, 44.7 per cent mesatice- 
phalic, and 10.5 per cent brachycephalic. In other words, 84.35 per 
cent of all these children were either long headed or round headed, 
and 15.65 per cent were broad headed. 

It is interesting to observe in Table V (p. 71) that the highest per 
cent of dolichocephalic children of German, Scandinavian, and 
Polish extraction was observed among those of Scandinavian origin, 
and the highest per cent of the brachycephalic of the same extrac- 
tion among children of Polish origin. These results are of great 
ethnical significance, though they may receive but passing notice in 
a re]3ort of this nature. 

PULSE AND RESPIRATION RATE. 

The rate of the pulse and respiration are influenced by age, sex, 
emotions, and many other factors. The average respiration rate 
per minute of 1,208 boys decreased gradually from 21.1 at the fifth 
year to 16,8 at the sixteenth year, rising again during the following 
two years, beyond which age the cases herein recorded are too few 
to give reliable indications. Although not so regularly as in the case 
of respiration, the pulse rate of 1,196 boys likewise decreased from 
92.05 per minute at the sixth year to 78 at the seventeenth year, above 
which age period the number of observations recorded are too few 
to compensate for the influences of emotion and exercise on the 
pulse rate. 

The average respiration per minute of 1,193 girls decreased grad- 
ually from 21.3 at the fifth year to 16.3 at the nineteenth year. A 
noticeable decline in the average respiration rate is recorded at the 
seventeenth year. The average pulse rate of 1,193 girls per minute 
decreased from 94.26 per minute at the fifth year to 74 per minute 
at the nineteenth year. Yariation in the pulse rate at different age 
periods was more marked in the case of girls than that of boys, 
which is probably accounted for by a more emotional temperament 
in the case of the former. 

NUTRITION. 

Observations on the nutrition of the pupils were made in the 
course of these examinations. The accuracy of these observations 
must necessarily be purely relative. The nutrition of 28 of the boys 
and 27 of the girls was considered fair. The development of 231 
boys, roughly 18 per cent of the total examined, and of 207 girls, 
or 16 per cent of the total, was fair. 



PHYSICAL DATA. 79 

Hemoglohin. — While the value of hemoglobin determinations as 
an index of nutrition is unquestioned, these tests could not be made 
generally. However, 158 boys were examined in this respect, using 
the Von Talquist scale. Of these, 3 boys had a hemoglobin per cent 
of 75; 16 of 80; 51 of 85; 77 of 90, and 11 of 95 per cent. Of the 
girls, 130 in number, 18 had a hemoglobin per cent of 80 ; 29 of 85 ; 
70 of 90; and 13 of 95 per cent. These determinations correspond 
quite closely to the observations relative to the nutrition of the 
pupils in the county as a whole. 

Diet. — As having a bearing on nutrition, observations were made 
with respect to the habitual use of certain articles of food by the 
school children of the county. The role of food in the causation of 
disease is becoming increasingly apparent. The effect of diet on 
scurvy has been known for a long time. A faulty food supply is 
definitely related to beriberi, and only quite recently it has been 
determined that a diet deficient in certain proteids stands in direct 
causative relation to the wide prevalence of pellagra. 

The breakfast of 901, or 40 per cent of the total children report- 
ing, was composed of carbohydrates principally, and that of 1,338, 
practically 60 per cent, was a mixed diet of carbohydrates and pro- 
teids. In addition, 1,277 children, or 57 per cent of the total, used 
coffee for breakfast, while only 315 children, or 15 per cent of those 
reporting, used milk. This condition is remarkable in an agricul- 
tural community in which dairy farming is so largely practiced. 
With respect to the use of starchy food, 839 children, or 37 per cent, 
had potatoes for breakfast, and 735 children, or 32 per cent, had some 
form of prepared cereal. Of the children whose breakfast contained 
some form of proteids 973, or 43 per cent, ate eggs for breakfast 
and 544, or 23 per cent, meat in some form, usually pork. 

Of the total reporting, 29 children did not eat breakfast habitually. 
In addition, the breakfast of a number of other children was defec- 
tive, largely through capriciousness of the appetite rather than in- 
ability of the parents to provide the necessary food supply. Ex- 
amples of this capriciousness may be seen in the case of some children 
who reported that their breakfast was composed of bread and coffee, 
pancakes, tea and crackers, coffee cake and coffee, pumpkin pie and 
coffee, an orange only in two instances, coffee and bread and lard 
in two other instances. This last observation is of peculiar interest 
in that it shows the retention of a custom or habit brought from the 
old country, because among certain Polish people lard is used on 
bread instead of butter, as a matter of choice. 

Parents should be impressed with the necessity of providing chil- 
dren with a substantial breakfast before proceeding to school, be- 
cause, in the cases where children live too far from the school to 
return for lunch, the amount of nourishment consumed by reason of 



80 



RUEAL SCHOOL SANITATION. 



these limitations is too small to afford proper nourishment. The 
child, improperly fed and poorly nourished, can not do effective 
work, either physical or mental. An empty stomach is incompatible 
with the acquirement of mental training. The requirements of a 
desirable diet are: That it be sufficient in amount, varied and well 
balanced, contain starches and sugars to furnish heat and energy, 
and proteids, most readily available in the form of beans, milk, 
eggs and fresh meat, for the repair and upbuilding of growing 
tissues. 

DEFECTS AND DISEASES FOUND. 

The belief is quite common that a greater number of rural school 
children suffer from physical defects than is the case in cities, be- 
cause of the greater medical facilities enjoyed by the latter. When 
compared with the reports of inspections made in urban communi- 
ties, the results of this survey do not confirm this belief. The fact 
remains, however, that an undue number of the children in rural 
schools are found suffering from the results of the misuse of the 
special senses and from diseases of these organs which require the 
services of specialists, unfortunately denied in great measure to this 
large part of the general population. 

In the following table is given the statistical results of the medi- 
cal examination of the children of Porter County : 

Table VI. — Physical defects found in an examination of 2,488 children attending 
the rural schools of Porter County, Ind. 



BOYS. 



Number. 



Circulatory system: 

Irregular heart action 

Valvular disease of 

Extremity, upper: 
Ankylosis — 

First and second fingers, right 

First finger, left , 

Second joint, fourth finger, right 

Third joint, second finger, right 

Fourth finger, left 

Contracture — 

First and second fingers, right 

Fourth finger, left 

Deformity — 

First, second, and fourth fingers, left 

Left forearm (old fracture) 

Bones, left forearm, recent 

Colle's, left, recent 

Hearing, defects of (see Tables VII and VIII) i 

Hernia: 

Inguinal- 
Left 

Eight 

Umbilical, relaxed ring 

Nervous system, paralysis, hemiplegia, cerebral type: 

Left 

Right - 

Nose and throat: 

Adenoids 2 

Nasal catarrh, chronic 

Nasal septum, deflected 

Nasal spur 

• Tonsils and adenoids associatedwith defective hearing in 97 cases. 
2 Adenoids associated with enlarged tonsils in 140 cases. 



1 
1 
1 
1 
1 

1 
1 

1 
1 

1 
1 

392 



3 
1 
1 

1 
1 

166 
16 
13 
14 



DEFECTS AND DISEASES. 



81 



Table VI. — Physical defects found in an exami/naUon of 2,488 children attending 
the rural schools of Porter County, Ind. — Continued. 



BOYS. 



Nose and throat— Continued. 
Pharyngitis— 

Catarrhal, subacute 

Chronic, atrophic 

Chronic, hypertrophic 

Soft palate, cleft 

Tonsils — 

Enlarged 

Requiring surgical treatment 

Respiratory system, general, bronchitis, subacut 
Skin: 

Eczema 

Impetigo 

Ringworm of the face 

Ringworm of the scalp 

Speech, defective 

Spinal curvature: 

Functional 

Organic 

Systemic: Pretubercular 

Teeth, defective , 

Vision, defective (see Tables IX and X) 

Total defects for boys 



Number. 



5 
2 
16 
1 

89 
10« 
15 

3 
3 
2 
2 



25 

2 

2 

749 

592 



2,228 



GIRLS. 



Number. 



Circulatory system: 

Irregular heart action 

Valvular disease of , 

Extremity, lower: 

Shortening of left leg, coxitis 

ArLkylosis, left hip, incomplete 

Extremity, upper: 
Anklyosis — 

Second finger, left 

Fourl h finger, both hands 

Second joint, fourth finger, right 

Deformity— 

Fourt h fmger, left hand 

Fourth finger, both hands 

Rudimentary fingers, fourth, both hands.. 
Hearing, defects of (see Tallies VII and VIII) i 
Nervous system: 
Paralysis- 
Infantile, both legs 

Spastic (infantile and cerebral type) . . . 

Infantile 

Nose and throat; 

Adenoids 2 

Nasal catarrh, chronic 

Nasal septum, deflected 

Nasal spiu- 

PharjTigitis — 

Catarrhal, subacute 

Chronic, atrophic 

Chronic, hypertrophic 

Tonsils- 
Enlarged 

Requiring surgical treatment 

Uvula absent 

Respiratory system, general: 

Asthma 

Bronchitis, subacute 

Tuberculosis 

Skin: 

Impetigo 

Ringworm of the face 

Ringworm of the scalp 

Speech, defective 

Spinal curvature: 

Functional 

Organic 

Systemic: Pretubercular 

Teeth, defective 

Vision, defective (see Tables IX and X) 

Total defects for girls 



1 
1 
I 

1 
1 

2 
348 



1 
1 
1 

122 
10 
6 



1 

31 

106 

84 

1 

1 

17 
2 

3 
3 
1 
6 

11 
2 
10 

637 
550 



1,985 



1 Tonsils and adenoids associated with defective hearing in 80 cases. 

2 Adenoids associated with enlarged tonsils in 110 cases. 



38062°— 16 6 



82 EUEAL SCHOOL SANITATION. 

In this table it will be observed that, although the school popula- 
tion of the county is almost equally divided between the sexes, 1,253 
boys and 1,235 girls, defects associated with the organs of hearing 
were more prevalent among the boys to the extent of 31.2 per cent 
compared to 28.2 per cent among the girls, affections of the respira- 
tory system including the upper air passages in 35.4 per cent of the 
former and 32.2 per cent of the latter, and defects of the visual ap- 
paratus in 47.2 per cent and 45.5 per cent of the boys and girls, 
respectively. A number of these defects, however, were of minor 
character. Their relative significance will be discussed under special 
headings. 

CIRCULATORY SYSTEM. 

Surprisingly few of the children examined during this survey 
presented grave disturbances of the circulatory system. Of the 
boys, only five were noted with valvular disease of the heart and two 
with irregular heart action. Among the girls were found three cases 
of valvular disease of the heart and one of irregular heart action. 

DEFORMITIES OF THE EXTREMITIES. 

Defects of both the upper and lower extremities encountered were 
of minor importance, the results in the main of minor accidents. 
They consisted largely of ankylosis of one or both joints of the 
fingers and of deformities following fracture of the long bones. In 
the case of the lower extremity, however, one girl was suffering 
from shortening of the leg due to a former inflammation of the 
hip joint and one from partial ankylosis of the hip due to the same 
cause. 

DEFECTIVE HEARING. 

Auditory acuteness was determined by a watch calibrated for the 
normal ear. Hearing was expressed in the form of a fraction, 
the distance at which a watch could be heard by the normal ear be- 
ing the denominator and the distance at which it was actually heard 
by the child examined, the numerator. In Table VII is given the 
results of the tests of hearing made in this manner : 



DEFECTS AND DISEASES. 



83 



Table VII. — Degree of impairment of hearing, in terms of tenths of the normal 
distance, in 16// boys and I'/O girls with defeetive hearing attending the rural 
schools of Porter County, Ind., 1914-15. 



Boys. 


Girls. 


Risrht 
hearing. 


Left 
hearing. 


Number. 


Right 
hearing. 


Left 
hearing. 


Number. 


0/0 


3/10 


1 


0/0 


8/10 




1/10 


1/10 


3 


1/10 


1/10 




1/10 


2/10 


1 


1/10 


2/10 




1/10 


3/10 


3 


1/10 


10/10 




1/10 


10/10 


1 


10/10 


1/10 




2/10 


1/10 


1 


2/10 


4/10 




5/10 


1/10 


2 


2/10 


10/10 




10/10 


1/10 


1 


4/10 


2/10 




2/10 


2/10 


2 


5/10 


2/10 




2/10 


3/10 


1 


6/10 


2/10 




2/10 


7/10 


1 


10/10 


2/10 




6/10 


2/10 


1 


3/10 


3/10 




3/10 


4/10 


2 


3/10 


9/10 




3/10 


10/10 


1 


4/10 


3/10 




10/10 


3/10 


2 


10/10 


3/10 




4/10 


4/10 


2 


4/10 


4/10 




4/10 


5/10 


1 


4/10 


5/10 




4/10 


7/10 


1 . 


4/10 


6/10 




4/10 


8/10 


1 


4/10 


8/10 




4/10 


9/10 


1 


4/10 


10/10 




4/10 


10/10 


2 


8/10 


4/10 




6/10 


4/10 


3 


10/10 


4/10 


10 


8/10 


4/10 


1 


5/10 


5/10 




10/10 


4/10 


3 


5/10 


7/10 




5/10 


5/10 


1 


5/10 


8/10 




5/10 


6/10 


1 


6/10 


6/10 




5/10 


9/10 


1 


6/10 


7/10 




5/10 


10/10 


•1 


6/10 


8/10 




9/10 


5/10 


1 


6/10 


9/10 




10/10 


5/10 


2 


7/10 


6/10 




6/10 


6/10 


S 


8/10 


6/10 




6/10 


7/10 


1 


9/10 


6/10 




6/10 


8/10 


2 


10/10 


6/10 


6 


6/10 


9/10 


2 


7/10 


7/10 


3 


6/10 


10/10 


3 


7/10 


8/10 


3 


7/10 


6/10 


1 


7/10 


9/10 


2 


S/10 


6/10 


1 


7/10 


10/10 


2 


10/10 


6/10 


3 


8/10 


7/10 


1 


7/10 


7/10 


4 


9/10 


7/10 


4 


7/10 


8/10 


2 


10/10 


7/10 


5 


7/10 


9/10 


1 


8/10 


8/10 


13 


7/10 


10/10 


2 


8/10 


9/10 


9 


8/10 


7/10 


1 


8/10 


10/10 


3 


9/10 


7/10 


1 


9/10 


8/10 


3 


10/10 


7/10 


5 


10/10 


8/10 


12 


8/10 


8/10 


20 


9/10 


9/10 


8 


8/10 


9/10 


2 


9/10 


10/10 


2 


8/10 


10/10 


8 


10/10 


9/10 


5 


9/10 


8/10 


1 






10/10 


8/10 


20 


Total for girls . . . 


140 


9/10 


9/10 


21 






9/.^0 


10/10 


5 






10/10 


9/10 


2 






Tota 


I for hoys... 


104 







Of the bo3^s, 1G4, or 13 per cent of the total examined, suffered 
from impaired hearing which ranged from the total loss of hearing 
in one ear to the ability to hear at 9/10 of the normal distance in 
one ear. Among girls, 140, or 11.3 per cent of the total examined, 
suffered from impairment of hearing extending over the same range 
as in the case of boys. 



84 



RURAL SCHOOL SANITATION. 



In Table VIII is tabulated the defects of hearing found among all 
the children examined during this survey: 

Table VIII. — Auditory defects in 2,-'f88 children attending the rural schools of 

Porter County, 



Defects. 



Males. 



Females. 



Total. 



Impairment of hearing in terms of tenths of the normal distance. 
Condition of ear drum: 

Adherent to promontory 

Congested 

Dull in one ear J 

DuU in both ears 

Obscured by ceremum and scales, one ear i 

Obscured by ceremum and scales, both ears ' 

Perforated in one ear , 

Perforated in both ears 

Retracted in one ear 

Retracted in both ears 

Retracted and duU in one ear 

Retracted and duU in both ears 

Deafness 

Discharging ears - 

Eczema, external auditory canal 

External auditory canal closed, injury •. 

Otitis media, subacute 

Otitis media, chronic 



5 

10 

37 

127 

85 

58 

27 

11 

97 

129 

35 

90 

1 

8 

1 

1 

5 

11 



Total. 



567 



475 



1 Associated with impaired hearing in 21 boys and 33 girls. 

In this table it will be observed that 24 children were suffering 
from inflammation of the middle and discharging ears, conditions 
which require prompt treatment to avoid involvement of the mastoid 
cells. Furthermore, 27 children suffered from perforations of the 
eardrum of one ear and 11 children of both ears, indicative of a past 
prevalence of inflammation of the middle ear with its potential 
dangers to life. 

Of more than passing interest was the presence of 21 boys and 33 
girls with impaired hearing due to accumulations of ceremum (wax) 
and scales in one or both ears. The unsuspected existence of so 
large a number of cases of impaired hearing due to causes so easily 
remedied and their hampering effect on intellectual training empha- 
size the need and the value of making school inspections more em- 
phatically than do defects of a more serious nature. 

It will be observed that 30.9 per cent of the boys and 26.3 per cent 
of the girls examined presented some impairment of the eardrum, 
langing from perforation to a slight dullness of one or both ear- 
drums. In all cases of adherent eardrums, dullness, congestion, and 
retraction the underlying causes are either some involvement of the 
middle ear or of the Eustachian tube. A number of these conditions 
of the eardrum demand treatment at an early date for the removal of 
the underlying causes in order to prevent more serious impairment 
of hearing later in life. 



DEFECTS AND DISEASES. 85 

NERVOUS SYSTEM. 

But few cases of involvement of the nervous system vrere observed 
during this survey. Tv\;'o boys, however, were suffering from paral- 
ysis of one side, the infantile cerebral type. Of the girls, one suf- 
fered from spastic paralysis of the infantile cerebral type, one from 
paralysis of both legs due to a previous attack of anterior polio- 
myelitis, and one from paralysis of one leg due to the same cause. 

DEFECTS OF NOSE AND THROAT. 

Adenoids. — Adenoids were present in 13.2 per cent of the boys and 
9.8 per cent of the girls. In all the cases noted the adenoids were 
developed to the extent requiring operative procedure. 

Adenoids exercise a harmful effect on the physical and mental de- 
velopment of the child. Adenoid tissue, represented most conspicu- 
ously by the tonsils, is normally present in the upper and back part 
of the throat just behind the posterior openings of the nasal passages. 
Overdevelopment of this structure in this situation results from 
causes not well understood, but generally thought to be due to irri- 
tation induced by variations in temperature and humidity associ- 
ated with poor ventilation. In time the free passage of air through 
the nose is restricted, mouth breathing supervenes, and the inspired 
air is not properly filtered, moistened, and warmed by contact with 
the nasal mucous membrane. 

Neglect of adenoids and failure to cause their prompt removal 
when indicated is responsible for a train of uncomfortable symp- 
toms, is fraught with danger to life, and is largely contributory to 
mental retardation and failure to make grade. 

Diseased tonsils and adenoids were associated with impaired hear- 
ing in 97 boys and 80 girls, or over 7 per cent of all the children 
examined during this survey. Adenoids were associated with en- 
larged tonsils, in all cases, in 250 children — 140 boys and 110 girls— 
or over 10 per cent of the total examined. 

Pharyngitis and nasal catarrh. — Inflammation of the upper air 
passages represented by chronic nasal catarrh and various grades of 
pharyngitis were observed in 39 boys and 50 girls, or 3.6 per cent 
of the total examined. 

Deflections of the nasal septum and nasal spurs were encountered 
among 27 boj^s and 15 girls, or 1.6 per cent of the total examined. 

Involvement of tonsils. — Enlarged or diseased tonsils were ob- 
served in 195 boys and 190 girls, or 15.4 per cent .of all children ex- 
amined. Not all of the enlarged tonsils observed were in need of 
immediate surgical attention, a distinction often overlooked, which 
causes children to be subjected needlessly to the nervous shock of an 
operation for the removal of tonsils simply because they are en- 



86 KUEAL SCHOOL SANITATION. 

larged. Tonsils in need of surgical attention were noted among 190 
children, or 7.6 per cent of the total examined. 

The tonsils readily become the seat of inflammatory processes, 
which are more or less chronic in character and which often extend 
to the middle ear, causing deafness. At times diseased tonsils are 
not enlarged but are embedded in the surrounding tissues, where 
they undergo slow suppuration followed by absorption of toxic sub- 
stances injurious to health. In cases of this nature the offending 
organs should be removed. 

DISEASES OF TIIE LUNGS. 

The school children of the county were remarkably free from dis- 
eases of the lungs. Only two cases of tuberculosis were encountered 
during this survey, both of them being girls. A very low, general 
tuberculosis rate is reported by the State and county health officials 
in Porter County. As stated elsewhere, 74 children reported the 
occurrence of tuberculosis in the family, which represents a total 
prevalence during a number of years rather than the actual number 
of cases of this disease in existence in families of school children at 
the time of this survey. 

In all, 2 boys and 10 girls were noted as being of a pretubercu- 
lar type. This classification included children with nutrition below 
par, small chest expansion, development under the average, and 
apparently diminished powers of resistance. 

The most frequent respiratory affection noted was a mild type of 
bronchitis, of which 15 cases were among boys and 17 among girls. 

Bronchial asthma was diagnosed positively in only one instance. 
Several children, however, reported themselves suffering from this 
affection, the existence of which could not be confirmed by physical 
examination. 

DISEASES OF THE SKIN. 

Cutaneous diseases were not noticeably prevalent among the school 
children of the county. A few cases of eczema and impetigo were 
noted. 

Ringworm of the face was observed in 2 boys and 3 girls, and 
ringworm of the scalp in 2 boys and 1 girl. Ringworm of the scalp 
is remarkably resistant to treatment. This disease is transmissible, 
is loathsome in appearance, and causes baldness. For this reason 
cases of ringworm should be excluded from school under treatment. 

DEFECTS OF THE TEETH. 

A total of 2,451 children were examined during this survey for 
dental defects, 1,236 boys and 1,215 girls. Of this number, 479 boys 
and 637 girls, 60 per cent of the former and 50 per cent of the latter, 
had some form of dental defects. 



DEFECTS AND DISEASES. 87 

Of the boys, 54.5 per cent had 2 or more defective teeth, and of the 
girls, 44.2 per cent. The highest percentages of defective teeth were 
observed among boys from the fifth to the eleventh year and among 
girls from the fifth to the tenth year. The reduction in the number 
of defective teeth during the following age periods was steady in 
the case of girls, but more irregular among the boys. 

The highest percentages of children with two or more teeth missing 
were encountered between the fifth and eleventh years among the 
boys and the fifth and ninth years among the girls, ranging from 28 
per cent in the fifth year and 45.5 per cent in the eighth year to 28.2 
per cent in the eleventh year. The per cent of the girls with two 
or more missing teeth ranged from 25.8 per cent during the fifth 
year, 37.5 per cent in the seventh year, and 2G.7 per cent in the ninth 
year. It will be observed, therefore, that the highest percentages of 
defective and missing teeth were encountered during the period of 
the deciduous teeth. The general average for boys was 23.4 and 
for girls 18.9. 

Malocclusion. — This was observed in marked degree, with equal 
frequency in boys and girls, in 4.8 per cent of those examined. 

Dental work. — The extent to which dental correction had been 
practiced Avas slight up to the eighth year. From this age period 
the percentage of dental work increased appreciably and in greater 
relative proportion among the girls for corresponding age periods. 
Of 20 boj^s and 28 girls at 17 years of age, 45 per cent of the boys 
and 71.5 per cent of the girls had had some form of dental work. 
The general average for boys was 14.1 and for girls 19.7. 

Toothbrush. — The use of the toothbrush by boys and girls presents 
some interesting comparisons. In all, 1,039 boys and 1,020 girls 
were classified with respect to the use of the toothbrush according 
to age periods, whether daily, occasionally, or never. Of the total, 
18.3 per cent of the boys and 10.5 per cent of the girls never used a 
toothbrush at all, 67.8 per cent of the boys and 48.6 per cent of the 
girls used the toothbrush occasionally, and the daily use of the tooth- 
brush was noted in but 13.9 per cent of the boys and in 40.9 per cent 
of the girls. 

The greatest number of children never using the toothbrush was 
encountered between the fifth to the ninth year age periods, boys 
in greater number than the girls. The daily and occasional use of 
the toothbrush increased with more advanced age among the boys, 
but among the girls the number using the toothbrush occasionally de- 
creased, while that of those using it daily increased. In other words, 
70 per cent of the girls at 6 years of age used the toothbrush occa- 
sionally, and 94 per cent of them used it daily at the eighteenth 
year. 



88 RURAL SCHOOL SANITATION. 

Oral hygiene. — The results of these examinations show the neces- 
sity of greater care of children's teeth in rural communities. Espe- 
cially is this true of deciduous, the so-called "milk" or temporary 
teeth. These should be preserved as long as possible. When the 
temporary teeth are lost too early or at too long an interval before 
the eruption of the permanent teeth, shortening of the jaw takes 
place, and the permanent teeth erupt in an irregular manner. 

The child should therefore be trained in the use of the toothbrush 
at an early age. ^ 

The undue number of children who never used the toothbrush, 
as revealed by these examinations, the still greater number who used 
it only occasionally, and the failure to provide for dental service in 
the case of the younger children call for greater attention on the part 
of the parents for the protection of the physical and mental fitness 
of their offspring. 

SPEECH DEFECTS. 

Two general types of speech defects are met with in school inspec- 
tion. In one class the children are without full control of the nerve 
mechanism of speech, a type represented by children who stammer. 
In the second class are those unable to articulate clearly because of 
some defect or deformity. Defective speech, when marked, prevents 
children from taking advantage of educational opportunity and, 
furthermore, in later life, renders it difficult for them to secure 
desirable positions. 

Except in populous districts where the total number of children 
so afflicted is proportionately great, the special teaching measures 
devised for these defects are not available for school purposes. 

In the course of this survey 8 boys and 6 girls with speech defects 
were encountered. The defect in the main was some form of stam- 
mering. 

SPINAL CTIRVATUEE AND EAULTY POSTURE. 

Deviations of the spinal column from the normal are either func- 
tional or organic in character. In the latter the defect is usually 
due to past or present involvement of the bony structure in some 
disease process. 

1 Certain rules for the preservation of the teetb recommended by the British Dental 
Association are as follows : 

1. The teeth should be cleaned at least once daily. 

2. The best time to clean the teeth is after the last meal. 

3. A small toothbrush should be used, brushing up and down and across, inside and 
outside, and between the teeth. 

4. A simple tootla powder or a little soap and some precipitated chalk taken iip on the 
brush may be used if the teeth are dirty or stained. 

5. It is a good practice to rinse the mouth out after every meal. 

6. The rough use of the teeth, such as cracking nuts, biting thread, etc., should be 
avoided, but the proper use of the teeth in chewing is good for them. 



DEFECTS AND DISEASES. 89 

The number of cases of spinal curvature due to organic lesions 
encountered during this survey was not large, there being but 2 
boys and 2 girls so afflicted. Of the so-called functional spinal 
curvatures, however, 25 were among boys and 11 among girls, largely 
of the lateral type. 

The most noticeable defect associated with faulty posture among 
school children is some form of functional spinal curvature. 

It is doubtful, however, if the school can be considered the most 
prominent factor in the production of spinal curvature. The prin- 
cipal and underlying cause of this defect is a weakened and relaxed 
musculature. This results in a tendency to assume slouching atti- 
tudes which has usually been contracted by the child before entering 
school. 

Effects of faulty posture on vision. — The relatively short anterio- 
posterior diameter of the eyes of very young children renders it 
difficult for them to see near objects without great efforts of accom- 
modation, during which the ocular muscles become fatigued. The 
assumption of postures which bring the work nearer the e^^es of 
young children therefore sets up a vicious train, the fatigue induced 
causing straining of accommodation, and still gi'eater bending of the 
head to secure a clearer image by this closer approximation. 

Other effects of faulty posture. — The habitual assumption of an 
incorrect posture with bended back and drooping shoulders causes 
contraction of the chest, incomplete expansion of the lungs, and re- 
duced aeration of the blood. The full nutritive value of the food 
supply is not utilized and children so hampered are usually anemic, 
flabby, and improperly developed. 

Although the school can not rightly be considered responsible for 
the tendency of children to assume faulty postures, it does crystallize, 
as it were, permanent faulty postural habits, unless measures be taken 
to overcome them. The installation of well-devised desks and their 
frequent adjustment to the needs of children insure the assumption 
of an upright position by placing the school work at a comfortal)le 
and convenient distance from the eyes. Children who display a 
tendency to faulty postures may and should have the muscle sense 
developed by appropriate regulated exercises. It must be remem- 
bered, however, that slouching attitudes are due to relaxation of 
easily fatigued muscles. Children of this type, therefore, require 
more frequent intervals of rest from positions of restraint than the 
normal child. 

HERNIA. 

Loss of tone by the abdominal muscles, caused by faulty postures, 
doubtless is responsible in a number of instances for the incidence 
of hernia. Hernias encountered among young children, however, 



90 



RURAL SCHOOL SANITATION". 



are usually congenital in type, the genesis of which has no connec- 
tion with habitual positions assumed by the child. Because of the 
restriction of physical examinations of this character in school 
work, the incidence of hernia among the school children of the 
county was considered from the standpoint of boys only. Among 
these, there were observed 6 cases of hernia, 4 of which were of the 
inguinal type and 1 umbilical. 

DEFECTS OF VISION. 

The association of two or more visual defects in the same subject 
was quite frequently observed during this survey. Including the 
errors of refraction, 1,335 visual defects were distributed among 
1,142 children, or not quite 1.2 defects for each child examined. 
Visual defects were present in 45.9 per cent of the total children ex- 
amined. The greatest number of visual disturbances encountered 
during this survey were due to errors of refraction which are tabu- 
lated in Table IX : 

Table IX. — Snellen chart visual test readings in 169 cases of faulty refraction. 



Boys. 


Girls. 


Right 


Left 


Number. 


Right 


Left 


Number. 


vision. 


vision. 




vision. 


vision. 




20/200 


20/200 




20/200 


20/200 


9 


20/200 


20/70 




20/200 


20/30 


3 


20/140 


20/200 




20/140 


20/140 


3 


20/50 


20/200 




20/70 


20/200 


1 


20/30 


20/200 




20/30 


20/200 


1 


20/100 


20/100 




0/0 


20/200 


1 


20/100 


20/20 




20/100 


20/100 


4 


20/100 


20/30 




20/100 


20/30 


1 


20/100 


20/40 




20/100 


20/40 


1 


20/20 


20/100 




20/SO 


20/100 


1 


20/70 


20/70 




20/70 


20/100 


2 


20/70 


20/20 




20/80 


20/80 


2 


20/50 


20/50 




20/70 


20/70 


4 


20/50 


20/30 




20/70 


20/50 


2 


20/50 


20/20 




20/70 


20/30 


1 


20/40 


20/50 


3 


20/50 


20/70 


1 


20/30 


20/50 


2 


20/40 


20/70 


1 


20/40 


20/40 


12 


20/50 


20/50 


10 


20/40 


20/30 


4 


20/50 


20/40 


3 


20/40 


20/20 


1 


20/50 


20/30 


5 


20/40 


0/0 


1 


20/50 


20/20 


1 


20/30 


20/40 


8 


20/40 


20/50 


4 


20/20 


20/40 


1 


20/30 


20/50 


1 






20/20 


20/50 


1 




Total for boys. 


67 


20/40 


20/40 


14 






20/40 


20/30 


10 






20/40 


20/20 


2 






20/30 


20/40 


12 






20/20 1 20/40 


1 






Tol 


al for girls.. 


102 



Only marked refractive errors were recorded in the table, errors 
which require correction by glasses. Of these there were 169 cases, 
67 boys and 102 girls, or 5.3 per cent of the former and 8.2 per cent 



DEFECTS AND DISEASES. 



91 



of the latter, among the total examined. It would seem, therefore, 
that refractive errors are almost twice as common among girls as 
among boys. Correction by glasses had been attempted in 33 in- 
stances, or in 19.2 per cent of those suffering from marked refrac- 
tive errors. 

The specific visual defects are recorded in the following table : 

Table X. — Defects of vision in 2,'iSS children aiiouliuff the rural schools of 

Porter Cotintij, Ind. 



Visual defects. 



Absorption of lens with opaque capsule, right 

Anemia ( nerve head), left 

Astigmatism: 

Against the rule, 1ioth eyes '. 

Against the rule, left eye only 

Against the rule, right eye only 

Against the rule, riglit, with the rule left eye 

With the rule, Ijoth eyes 

With the rule, left eye only 

With the rule, right eye only , 

With the rule, right, against the rule left eye 

Mixed 

Atrophy, tissues of orbit 

Blepharitis 

Blind, one eye: 

Right 

Left 

Choroid, pathological accumulation of pigment 

Choroid, thinned 

Coloboma of choroid and iris, left 

Congestion of nerve head, left 

Conus: 

Infratraction 

Supratraction 

Defective color sense 

Exophoria 

Hordeolum 

Hyperopia, marked 

Iris, adherent, central leucoma 

Myopia: 

Marked 

Right eye, hyperopia, left eye 

Nebulae with defective vision . ." 

Nystagmus, spontaneous 

Polycoria, left 

Opacity, hoth lenses, congenital 

Strabismus: 

E xternal 

Internal 

Trachoma 

Vision uncorrected, 20/200 to 20/40 in one or both eyes 

Total 



Males. 




3 

75 

45 

37 

30 

139 

62 

60 

46 



1 

2.S 

1 
1 
1 

1 


2 
1 

26 
3 
2 

10 


4 


3 
1 


1 

S 

5 

67 



Fe- 
males. 



1 

3 

63 

51 

SO 

34 

111 

57 

59 

33 

1 



45 

4 


1 


1 

2 
3 
3 
1 
4 



15 
1 
3 
2 

1 



6 

2 

102 



Total. 



1 

6 

138 

96 

87 

64 

250 

119 

119 

79 

1 

1 

73 

5 
1 
1 
1 
1 
1 

4 
4 

29 
4 
6 

22 
1 

19 
1 
3 
5 
1 
1 

1 

14 

7 

169 



1,335 



Astigmatism. — Astigmatism was present in one or both eyes 
among 953 children, or 38.3 per cent of the total. With regard to 
sex, 39.4 per cent of the boys and 36.3 per cent of the girls were 
astigmatic. 

Hyperopia, — Hyperopia was determined by the ophthalmoscope 
and only marked cases of this refractive error were recorded because 
the eyes of young children are normally hyperopic. Twenty-two 
cases of hyperopia were recorded, 10 of them in boys and 12 in 
girls. 

Myopia. — This was likewise determined by the opthalmoscope and 
the marked cases only were recorded. Of these, there were noted 



92 BUEAL SCHOOL SANITATION. 

19 cases, 4 in boys and 15 in girls. It is seen from the foregoing 
observations that refractive errors of all types were encountered 
among girls in larger proportion than among boys. 

Extreme types of myopia are found associated with poor school, 
environment more frequently, probably, than any other form of 
grave refractive error. The influence of marked myopia upon the 
future possibilities of the child is very pronounced, limiting to a 
noticeable degree the occupations in which he can engage. 

In schools he should be protected from glare and undue bright- 
ness and provided with a desk of such a type that the work may be 
placed at the most suitable angle and distance for visual comfort. 
Although there may be doubt that faulty position and poor illumi- 
nation and posture are causative factors of myopia, still it is well 
recognized that these conditions may intensify the degree of myopia 
originally present. 

Defective color sense. — This was noted in the case of 29 children, 
26 of these being boys and 3 girls. The inability to distinguish colors 
limits the number of occupations in which boys so afflicted may 
profitably engage. This is especially true in railroading, navigation, 
and in the manufacture of certain textiles. It is a singular fact that 
a number of people with faulty color sense are unaware of this 
defect. The determination of this fault at an early age, therefore, 
may be of value in directing the activities of the child to fit him for 
occupations in which the possession of the normal color sense is not 
a matter of such great importance. 

Trachoma. — Trachoma is a contagious disease of the eyes poten- 
tially dangerous to vision. This disease is now known to be more 
widely prevalent in this country than was formerly thought to be 
the case. Unfortunately mild types of trachoma may exist without 
producing noticeable symptoms for long periods, yet eyes in this 
condition are potentially infectious to others. The necessity for the 
inspection of the eyes of school children for the detection of cases 
of trachoma is therefore apparent. 

In the course of this survey but 7 cases of trachoma were en- 
countered, 5 among boys and 2 among girls. The slight prevalence 
of trachoma in Porter County, Ind., as indicated by these figures, 
is an evidence of the care exercised in the inspections for this disease 
at the ports of entry, because a considerable proportion of the popu- 
lation of this county is drawn from sections of Europe in which 
trachoma prevails extensively, 

GOITEE. 

Simple thyroid enlargement, commonly called goiter, is more or 
less prevalent in practically all localities. This condition, however, 
has been found unduly prevalent in regions underlaid by ancient 



DEFECTS AND DISEASES. 93 

limestone formations. The actual cause of goiter has not yet been 
determined, though by many it is thought to be due to the drinking 
of unduly hard waters. While the presence of simple thyroid en- 
largement is not particularly harmful, nevertheless from the esthetic 
standpoint its correction is highly desirable. 

Records were made, therefore, of the prevalence of this defect 
among the school children of the county and classified according to 
whether the enlargement was pronounced or only slightly noticeable. 
Among the 2,488 children examined, 872 girls and 048 boys, or 61 per 
cent of the total examined, presented some degree of thyroid en- 
largement. Of the 1,235 girls examined, 43.4 per cent presented 
noticeable thyroid enlargement, and in 24.3 per cent it was only 
slightly so. Of the 1,253 boys examined, 26.7 per cent presented 
noticeable thyroid enlargement and in 27.6 per cent the enlargement 
was slight. The distribution of goiter in this county is remarkable 
in that this gland is involved in such a high percentage of the boys 
examined, in marked contrast to the observations of one of the writers 
(Dr. Clark) in other localities. 



PART m. 



MENTAL STATUS OF RURAL SCHOOL CHILDREN OF 
PORTER COUNTY. 

In the course of this survey, a study was made of the mental con- 
dition of each child. The purpose was not only to determine the 
number of mental defectives which require special or individual 
treatment, but to study the influence of school surroundings on men- 
tal status. Coincidently, studies were made to determine the value 
of the Binet- Simon tests for grading intelligence. 

A total of 2,185 children were thus examined, special reliance 
being placed in the Binet tests with some modifications. In the case 
of exceptionally retarded children revealed by these tests, however, 
special methods were employed to determine the degree of mental 
impairment. 

HISTORY OF THE TESTS. 

As is known, Binet and Simon, on data collected during the 
examination of 200 normal French school children, devised a series of 
tests for different age periods. As originally devised, the number of 
tests for each age group varied from four to seven. In 1911, the 
tests were revised and the number for each age group was fixed at 
five, except that of the four-year group, which contains four tests. 
This revision was based on the examination of 203 French school 
children. Of this number, the observers gave tabular results for 
192, as follows: 



Table XI.- 



-Mental and chronological ages of 192 French school children exam- 
ined by Binet and Simon.^ 



Chronological age. 


3 


4 


5 


6 


7 


S 


9 


10 


11 


12 


Total. 




3 
3 


9 
2 
1 
4 
1 


13 
6 


5 
S 


7 


16 
5 
1 
1 


11 
9 


14 
2 


13 


2 


93 




42 








2 




4 


4 


6 
1 


3 
1 


2 


9 
3 


5 
2 


5 

4 


43 




12 












Total • ^ 


10 


17 


23 


20 


18 


23 


22 


28 


20 


11 


192 







1 In this classification, "regular" signifies that the child's mental age is the same as the chronological age. 
Advanced and retarded are self-explanatory. 

94 



HISTORY OF TESTS. 



95 



It will be observed in the above table that nearly half the children 
were regarded as regular, while those retarded and those advanced 
one year were about equal in number. Only 14 of the 192 showed 
a departure from the regular of more than one year. 

These tests were the first of this character devised for the purpose 
of determining the degree of intelligence of children in terms of 
mental ages. By reason of their simplicity they became widely 
popular. 

The tests have been objected to by some on the ground that they 
are mainly tests of the intelligence. They certainly do not aim at 
a systematic determination of the development of any particular 
mental function. They have been found, however, in an empirical 
way to give results which show the general mental development 
of the child. 

The Binet-Simon tests do not extend bej^ond the chronological 
age of 12, because, following this age period, the mental content 
becomes more intricate, and a small number of tests at any sub- 
sequent age would be far from accurate. 

Because of the objection that Binet and Simon examined too 
small a number of children to establish norms, Goddard determined 
the norms for these tests in the case of 2,000 American school chil- 
dren. His results in the case of 1,532 children are given in the fol- 
lowing table : 

Table XII. — Mental and chronological ages of 1,532 American school children 

examined bg Goddard. 





Chronological age. 


Mental age. 




2 


3 


4 


5 


6 


7 


' 8 


9 


10 


11 


12 


13 


Total. 


4 




1 

4 

.... 


2 

8 
3 
2 
2 


40 

29 
8 
2 


3 

40 

48 

15 

1 
















8 


5 


2 

1 


16 
69 
14 

87 
27 
15 
4 
4 
1 


4 

9 

50 

86 

54 

24 

13 

10 

5 

1 












114 


6 


'"4 
16 
56 

19 
25 
13 
6 

1 
3 


1 

3 

12 

58 

124 

50 

42 

30 

6 








160 


7 








197 


8 




3 

4 

27 

60 

36 

19 

5 

1 






209 


9 






2 

8 

12 

39 

21 

4 

2 


2 

i 
7 
3 


201 


10 












219 


11 












165 


12 












151 


13 












85 


14 












17 


15 














6 




Total 




















3 


6 


17 


81 


107 


337 


256 


143 


326 


155 


88 


13 


1,532 









It will be observed in the above table that up to the age of 9 
nearly all of the children of each age group graded either regular, 
one year advanced or one year retarded. In the succeeding age 
groups, nearly all of them graded either regular, one year advanced 
or two years retarded with the exception of the 10-year-age group, 
in which nearly as many children graded three years retarded as 
were retarded only one year. 



96 



RURAL SCHOOL SANITATION. 



METHOD OF EXAMINATION AND GRADING. 

Goddard's revision of the Binet-Simon scale, with the addition 
of his 15-year old and adult test groups, was used in this survey. 
In one-room schools the children were examined in the classroom, 
in schools of more than one room in a room where physical examina- 
tions were being made. In other words, the examination was not 
made in a quiet place, but in one that represented in part the child's 
daily schoolroom environment. 

The following method of grading was employed : The child was 
given a basal mental age corresponding to the age group in which 
he successfully passed all the tests, and to this one year was added 
for each five tests passed successfully in the higher age groups. For 
example, if in addition to all the 8-year tests he also passed 3 in 
the 9-year group and 2 in the 10-year group, he was graded as hav- 
ing a mental age of 9 years. 

In the case of the 12-year-old group, however, in view of the in- 
ability of a large number of 12-year-old children to repeat a sen- 
tence of 24 syllables, a child successfully passing all five of these 
tests and one of the 15-year group was classed as 13 mentally. 

Children were classed as 15 years old mentally when they passed 
all of the 15-year-old tests but less than half of the adult tests, and 
as adults when they passed 75 per cent of the adult tests. 

Statistical results of the application of the Binet-Simon tests to 
2,185 rural school children of Porter County in the first to eighth 
grades inclusive, are given in the following table :^ 

RESULTS OF MENTAL EXAMINATION. 

Table XIII. — Chronological and mental ages of 2,1S5 children attending the 
rural schools of Porter County, Ind., in terms of per cent. 





Mental age in terms of per cent of the total in each age group. 


Chronological age. 


4 


5 


6 


7 


8 


9 


10 


11 


12 


13 


15 


A. 


Total 
exam- 
ined. 


5 




33 + 

18.7 

5.6 

1.7 

.92 

.36 


42.25 
27.+ 
23.7 

6.0 

.3.7 
.72 


23 + 
33.7 
37.9 

12 
6.5 
2.5 

1.8 


11.5+ 

16.8 

25.8 

44.5 

29.1 

16.3 

6.6 

2.6 

2.4 
.55 

2.9 
















26 


6 


2.8 
.43 
.42 
.92 


'5.'2'" 
18.8 
31.4 
23.7 

9.9 
10.3 

5.6 

4.9 
11.7 

7+ 

9 + 


0.93 

8.6 

6.4 
22.7 
40.7 
35.3 
21.0 
19.5 

7.7 

8.8 
10.5+ 

9.0+ 












107 


7 


'2."i" 
4.1 
12.9 
35.3 

37.8 

35.8 

28.7 

14.7 

15.8+ 

18.2 

50 


0.43 








232 


8 








234 


9 


.46 
2.5 
8.9 
33.3 

20.1 

24.3 

13.4 

22.8+ 

18.2 

50 








216 


10 


0.36 
1.8 
5.7 
13.6 

21.5 
19 + 

14 + 
9 + 






278 


11 








212 


12 








0.82 
2.8 
11.6 
38 + 
28 + 
18.2 


'ia" 

1.7+ 
9 + 


243 


13 








.4 
.55 


249 


14 ... 








181 


15 








136 


16 










57 


17 










9 + 


11 


18 










2 


19 
























20 




















100. 






1 




























Total 


7 


46 


119 


204 


324 


280 


387 


390 


210 


128 


86 


4 


2,185 



''■ In this tabulation a child was recorded as having the chronological age of his nearest 
birthday and likewise as having the nearest mental age (when grading mentally in frac- 
tions of a year. 



RESULTS OF MENTAL EXAMINATION. 97 

LIMITS OF NORMALITY. 

A glance at the foregoing tables of Binet-Simon and Gocldard will 
show that large numbers of normal children, chronologically 6, 7, 8, 
and 9 years of age, graded either regular, one year advanced, or one 
year retarded. In the case of children 10, 11, and 12 years old, chro- 
nologically, large numbers graded either regular, one year advanced, 
or one or two years retarded. 

In the case of 13-year-old children, however, those retarded as 
much as three years are regarded as normal, because nearly all of 
the children of the series come within these limits. Thirteen-year-old 
children who grade 15, however, must be regarded as " exceptional 
children." The 14, 15, and 16 year old children graded largely 
within the limits of 11 and 15 years mentally and those of 17 to 20 
years of age from 12 to adult. 

CLASSIFICATION OF RETARDED AND EXCEPTIONALLY RETARDED CHILDREN. 

The mental progress of a child is rapid for the first few years of 
its life but becomes slower as maturity is approached. There is, 
as yet, no means of measuring this rate of progress. The difference 
in the mental development of a normal 2-year-old child and one 3 
years old is readily recognized. This difference becomes difficult to 
note between the ages of 6 and 7, and between 11 and 12 years of 
age the recognition of mental difference by ordinary observation is 
quite impossible. 

Mental development during any one-year period does not represent 
accurately a unit of mental growth, because the older the child the 
less rapid is the rate of mental development and the less noticeable 
is the retardation in any one year age period. 

Moreover, retardation in very young children presents two possi- 
bilities. In the first place, owing to the greater number of years 
intervening before maturity, these children eventually may attain 
normal mental development. On the other hand, retardation may 
accumulate and become increasingly evident with advancing age. 
In consequence, the ultimate mental development of young children 
thus classified can not be foretold. 

The problem is not so complex, however, in the case of adults or 
individuals who have reached a chronological age at which the rate 
of mental development is slower. Retardation below a certain point 
can not be overcome in the short time intervening before maturity 
at the slower rate of development, and the mental status in these 
cases may be determined with certainty. 

The classification used in this report is based on the above con- 
siderations and children are recorded as retarded and exceptionally 
38062°— 16 7 



98 RURAL SCHOOL SANITATION. 

retarded. With the former the possibility^ remains of ultimate 
normal mental development, while with the latter the mental de- 
A'^elopment will never be greater than that of a child when adult 
age is reached. 

A graphic representation of the classification employed in these 
studies is shown in chart 10. Reference to it will show that children 
of 6 years who were 4 mentally, of 7 who were 5, of 8 who were 
5 or 6, of 9 who were 6 or 7, of 10 who were 6 or 7, of 11 who were 
7 or 8, of 12 or 13 who were 8 or 9, of 14 or 15 who were 9 or 10, 
of 16 who were 10, of 17 to 20 who were 11, are classified as excep- 
tionally retarded. 

The method of classification used is considered conservative. 
Although this classification may not include all the mental defectives 
in a school population, because of the inability to determine posi- 
tively subnormality in the very young children of the lower grades, 
and who must, therefore, be regarded as retarded only, still the 
method is more reliable than the arbitrary grading children as defec- 
tives who are retarded as much as three years. The adoption of 
the latter procedure would have recorded a percentage of feeble 
mindedness for this county far in excess of actual conditions. 

RETARDED CHILDREN. 

Retarded children are to be found in every large school system. 
It has been stated that 50 in every 1,000 public school children have 
difficulty in keeping up with their work and are in need of indi- 
vidual assistance. 

Of the 1,087 girls and 1,098 boys examined in the rural schools of 
Porter County, 93 of the former and 100 of the latter were retarded, 
and excluding the exceptionally retarded children, constituted 8.7 
per cent of the number examined. Including the exceptionally 
retarded children, the whole number of children requiring special 
attention was 214 or 9.3 per cent. 

DEFECTS ASSOCIATED AVITII RETARDATION. 

The delicate physical and mental adjustments of children are 
much more easily upset than is the case with adults. Minor physical 
defects which ordinarily make no impression upon a grown person 
may prevent the normal physical and mental growth of the child. 
Defects of vision and hearing, defective teeth, adenoids, enlarged 
tonsils, nutritional disturbances, and certain general diseases react 
injuriously on both the physical and mental development of the 
child. It becomes important, therefore, to consider the hampering 
effects of physical defects and diseases in connection with mental 
retardation, and to take steps for their correction when possible. 



RETARDED CHILDREN. 



99 




S/GN/F/ES CHILDREN HITHIN NOf^M/IL LIMITS. 




RBT/iROED CH/LDR£N. 




£XC£Pr/0/Si/ilL Y RE T/iRDEO CHILDREAf, 
THE /iOVAAfCED OR EXCEPT/ONRL CHILD^ 

U.S. Public Health 5E«v/ce. 

Chaut 10. — Normal mental age limits for one-year chronological age periods, and limits for 
advanced, retarded, and exceptionally retarded children, measured by Binet-Simon scale. 



D 



/y 



A 



100 BUEAL SCHOOL SAISTITATION. 

Thirty-five per cent of the 93 retarded girls found in the rural 
schools of Porter County were undersized, 41.1 per cent were of 
normal size, and 23.5 per cent were above the county average in 
height and weight. Furthermore, 58.8 per cent had defective eye- 
sight, 26.4 per cent had defective hearing, 1.7 per cent had adenoids 
associated with enlarged tonsils, 2.9 per cent had enlarged tonsils 
without adenoids, and 17.6 per cent had defective teeth. 

Thirty-eight per cent of the 100 retarded boys were undersized, 
30 per cent were of normal stature, and 32 per cent were above the 
county average of height and weight. In addition, 47 per cent had 
defective eyesight, 19 per cent had confused color discrimination, 
34 per cent had defective hearing, 6 per cent had adenoids and 
enlarged tonsils, 17 per cent had defective teeth, and one child had 
a cleft palate. 

Two or more physical defects were frequently associated in the 
same child. 

OTHEE CAUSES OF MENTAL RETARDATION. 

Improper teaching methods are responsible for much of the 
i-etardation found in schools. The teachers of the public schools 
of the country have imposed upon them a great responsibility, no 
small part of which is the molding of character. Education is some- 
thing more than imparting instruction. Young people who adopt 
teaching as a temporary avocation do not meet with the same success 
in. training children as do those who make this profession a life 
work. The training of teachers, therefore, and their selection, war- 
rants the most careful consideration, because, in addition to technical 
training, the successful teacher must be adaptable and have the 
ability to broaden the outlook upon life of certain types of intro- 
spective children. 

Poorly equipped school buildings, defective illumination, faulty 
ventilation and heating, uncomfortable seats and unattractive sur- 
roundings operate to cause retardation. The discomfort experienced 
in buildings of this type produces a hampering effect on the mental 
concentration necessary for educational purposes. The provision 
of school buildings erected in accordance with modern sanitary prin- 
ciples will do much to reduce the amount of retardation appearing 
in school children. 

In a number of instances, children have been advanced in grade 
without proper preparation. A child who has failed to acquire the 
fundamentals in a lower grade can not properly do the work in the 
higher classes and, when unduly promoted, suffers injurious re- 
tardation. Children of this type frequently quit school with a poor 
educational equipment. 



RETARDED CHILDREN". 101 

In Porter County the average loss of grade by retarded children, 
as recorded by teachers, was 1.28 years for girls and 1.5 years for 
boys. 

Mental retardation is most frequently met with in crowded one- 
room schools where several grades are taught by one teacher. A 
number of schools of this type are in operation in Porter County. 
Where the number of pupils in attendance is large, the time of the 
teacher is too occupied by routine duties to permit of individual in- 
struction of children who find difficulty in mastering the funda- 
mentals of education. 

CARE or RETARDED CHILDREN. 

Children who are unable to advance in school work by methods 
which are effective in regular classes require special educational fa- 
cilities, which are of practical attainment through the organiza- 
tion of special classes. The organization of such classes rarely can 
be accomplished in districts where there are principally one-room 
schools by reason of the increased cost. The consolidation of rural 
schools, however, offers facilities for special classes and individual 
instruction to larger groups of children, who would otherwise re- 
main misfits in the smaller schools. 

Wherever such classes are organized, the retarded children should 
not be segregated in the most undesirable rooln in the building. 
Moreover, the teachers should have special qualifications for this 
kind of instruction and not be selected because of years of expe- 
rience in other brandies of pedagogy. They should have training in 
the management of children, a knowledge of the methods employed in 
correcting speech defects, and a fair understanding of some of the 
problems of psychology as related to the child and of the principles 
of physiology. 

The value of special classes for retarded children is shown by the 
fact that 50 per cent of the children who are placed in such classes 
rejoin their proper grade when faulty methods are corrected and 
physical conditions improved. 

EXCEPTIONALLY RETARDED CHILDREN. 

Of the 1,087 girls and 1,098 boys examined in the rural schools 
of Porter County, 7 or 0.6 per cent of the former, and 14 or 1.2 per 
cent of the latter were so exceptionally retarded that their mental 
development at no time will be greater than that of a child. 

DEFECTS ASSOCIATED WITH EXCEPTIONAL RETARDATION. 

Twenty-eight per cent of the exceptionally retarded girls were 
undersized and 57 per cent were above the average physical develop- 
ment of the county, as compared with only 23.5 per cent of the girls 



102 EUEAL SCHOOL SAISTITATIOF. 

who were simply retarded. Furthermore, 42.8 per cent had defec- 
tive eyesight, 14.2 per cent had defective hearing, and 2.9 per cent 
had enlarged tonsils. 

Of the exceptionally retarded boys, 28.5 per cent were under- 
sized, 28.5 per cent were of normal physical development, and 42.8 
per cent were above the average for the county in height and weight. 
In addition, 34.2 per cent had defective eyesight, 57.1 per cent had 
defective hearing, and 7.1 per cent had enlarged tonsils. 

Among the exceptionally retarded children the average loss of 
grade, as recorded by teachers, was 2.1 years for girls and 2.5 years 
for boys. 

The number of exceptionally retarded children constituted 0.9 
per cent of the total number examined. This does not include all 
of the defectives among children of school age in the county. It 
must be assumed that some children, by reason of grave mental 
defects, were unable to attend school. 

CHAKACTERISTICS OF EXCEPTIONAL RETARDATION. 

Mental deficiency, or feeble-mindedness, as it is more often termed, 
has been defined as a lack of normal mental development. Individ- 
uals of this class can be educated to a degree, but with them mental 
progress is so decidedly slow that their mental capacity is no 
greater than that of a child, even when adult life is reached. Per- 
sons whose intelligence is developed to so slight a degree are misfits 
in a society arranged for people whose mental develo]3ment contin- 
ues until the retrogressive changes of old age begin. They become 
dependents because of their inability to compete with persons of 
higher intelligence, immoral because unable to adjust their sexual 
problems to moral laws, and delinquent because they do not under- 
stand the significance of laws devised for the protection of society. 

CAUSES OF EXCEPTIONAL RETARDATION. 

A defective heredity, insanity, alcoholism, and syphilis in one or 
both parents are considered responsible for most of the cases of 
mental defectives. A large part of the evidence that heredity is an 
important causative factor of mental deficiency is based on indirect 
testimony. The great value of investigations of this character is 
the determination of existing cases of mental deficiency as a start- 
ing point for future studies of the influences of heredity on succeed- 
ing generations. 

Of the other causes of mental deficiency may be mentioned con- 
genital defects, injuries, and nutritional disturbances. Improvement 
by better sanitation of the health of communities will be followed 
also by a reduction in the number of mental defectives. 



EXCEPTIONALLY BETARDED CHILDREN. 103 

NUMBER OF EXCEPTIONALLY RETARDED CHILDREN. 

According to the United States census report, 1910, 20,000 mental 
defectives were in special institutions in this country. Mental exami- 
nations of a large number of persons in prisons, penitentiaries, jails, 
and workhouses during the last few years show at least a third of the 
number examined to be mentally defective. At this rate not less 
than 40,000 of the 136,472 persons in such institutions, including those 
for juvenile delinquents, in 1910 were mental defectives. 

It has been estimated that 20 in each 1,000 American school 
children are mental defectives,^ and that 2 in 1,000 of the general 
population are mental defectives. On the basis of the lowest figures 
it is estimated there are at least .200,000 feeble-minded persons in the 
United States. As a conservative estimate, about 130,000 feeble- 
minded persons are without institutional care of any description. 
Only 26 States have provided institutions for the feeble-minded. 

CARE OF MENTAL DEFECTIVES IN INDIANA. 

In 1879 a department for feeble-minded children was established 
as an adjunct to the Soldiers' and Sailors' Orphans' Home at 
Knightstown, Ind. The legislature, by an act approved March 7, 
1887, gave the institution an independent existence and changed the 
name to Indiana School for Feeble-Minded Youth. A new institu- 
tion was built at Fort Wayne. It was not occupied, however, until 
July 8, 1890. 

The privileges of the school are extended to feeble-minded, idiotic, 
epileptic, and paralytic children under 16 years of age. Since 1901 
the school has maintained a custodial department for feeble-minded 
w-omen between the ages of 16 and 45 years. These women are com- 
mitted by the courts (Laws, 1887, p. 47; 1901, p. 156). A colony 
farm containing 509^ acres has been in operation since 1893. 

The superintendent of the various almshouses in Indiana, in 1914, 
reported 489 feeble-minded men and 380 feeble-minded women in 
the various almshouses of the State. Of the 380 feeble-minded wo- 
men, 118 were within the child-bearing age period. Of the 3,228 
almshouse inmates, 1,389, or 43 per cent, w^ere insane, feeble-minded, 
or epileptic.^ 

EDUCATION OF FEEBLE-MINDED. 

The aim of the education of feeble-minded children should be to 
train them to be self-supporting. Intellectual training, in its nar- 
rower sense, is of secondary importance. 

iThe number of mental defectives found in tliis survey are not greater than 9 in 1,000. 
2 Twenty-fiftli Annual Report of the Board of Charities of Indiana, September, 1914. 



104 HUEAL SCHOOL SANITATIOl^* 

Most American institutions for the feeble-minded are broadly 
divided into two departments — educational and custodial. The edu- 
cation of the feeble-minded, compared to that for normal children, 
differs in degree only and begins at a lower plane. Satisfactory 
gradations or classifications are made so that children with irregular 
and unusual deficiencies receive individual training in special classes. 

The most prominent feature of the education of the feeble-minded, 
however, is their training in industrial occupations and manual labor, 
as now successfully and profitably carried on by the pupils in these 
schools. Through correct training of this character a certain num- 
ber of these individuals lead useful lives after leaving the institu- 
tions. About one-half the higher grades of mental defectives who 
have been under training from childhood are self-supporting, under 
intelligent supervision, whether in an institution or at home. It is 
especially important to begin training of this character early in the 
child's life. 

MENTAL DEFICIENCY AND ITS RELATION TO THE COMMUNITY. 

Recent investigations of the defective and delinquent classes have 
demonstrated that a large percentage of criminals, paupers, tramps, 
and prostitutes are really congentital imbeciles who have been al- 
lowed to grow up without training or discipline. Society suffers the 
penalty of such neglect through an increase in jDauperism, vice, and 
crime, and the greatly increased cost of the care of adult feeble- 
minded persons. 

Feeble-minded girls, exposed to evil influences, are unable to pro- 
tect themselves from the perils peculiar to women. There is hardly 
a poorhouse in this country which has not one or more feeble-minded 
women who are mothers of several illegitimate children. It is often 
the case, in rural communities, that a girl of this type, when illegiti- 
mately pregnant, has no place to go except to the almshouse. After 
the community has borne the expense of three or four confinements, 
she is finally committed to an institution for the feeble-minded. 
From every consideration of morality, humanity, and public policy, 
feeble-minded women should be under permanent and watchful 
guardianship, especially during the child-bearing age. 

OTHER MENTAL CONDITIONS WHICH REQUIRE SUPERVISION. 

EPILEPTICS. 

During the course of this survey three epileptic children were 
observed. One of these was feeble-minded. 

The State of Indiana has provided an institution for cases of this 
type, which is located near New Castle. All epileptics having a 
legal settlement in the State are admissible. 



OTHER MENTAL CONDITIONS WHICH EEQUIRE SUPERVISION. 105 

Recent studies of jiiA^enile offenders show that a fair per cent 
of them are afflicted with epilepsy. It is estimated that every 
juvenile epileptic offender, because of his constitutional tendency to 
corrupt others, in the end will cost the State the sum of $6,000. It 
is important, therefore, for communities to realize that, because men- 
tal conditions play no small part in the production of crime, early 
recognition of these cases and suitable provisions for their super- 
vision and training will obviate future expense. 

JUVENILE DELINQUENT. 

In every community there is a number of children who are morally 
irresponsible. They showed no marked deficiency of the intellectual 
faculties, but early in childhood manifest a perversion of the moral 
sense, which is shown by motiveless, persistent lying and thieving, 
an impulse to arson and cruelty to animals and to younger or help- 
less companions. These constitutionally inferior persons comprise 
a large percentage of habitual criminals. The presence of one or 
more children of this type in school exercises a pernicious influence 
that is usually associated with an increase in the number of children 
who fail to make grade. It is undesirable to permit children of this 
type to attend school. It is still more undesirable to turn them loose 
on the community without restraint, because they are potential crimi- 
nals in a poor environment. It is incumbent on the State, therefore, 
to care for such children and give them suitable training. 

During the course of this survey two marked cases of this type 
of mentality were found. 

State provision for juvenile offenders. — The State of Indiana has 
established two schools for the correction and reformation of juvenile 
offenders. That for boys is established on a farm near Plainfield and 
receives boys committed for crime from 8 to 16 years of age. In the 
case of incorrigibility, however, the commitment age is from 10 to 17. 
The term of commitment continues until the boy is 21 years of age. 
One-half of the cost of caring for each boy is paid by the county 
from which he is committed. 

The daily average attendance is near 600 boys. 

The Indiana girls' school is situated on a farm near Clarmont. 
The age of commitment for girls is from 10 to 18 years of age. The 
term of commitment is until 21 years of age. 

The daily average attendance is a little over 300. 

In Indiana the judge of the circuit court is the guardian of all 
children who need State protection. In addition the State has 
formed a board of children's guardians, which is composed of six 
members, three of whom are required to be women. Each member 
must be a parent. 



106 RURAL SCHOOL SANITATION". 

The practice of committing juvenile offenders without an attempt 
to determine their mental status is not a good one. The possibility 
of a miscarriage of justice by this procedure is very great. It is 
desirable that courts which deal with children should have attached 
to them a competent psychologist to determine the children's mental 
status. Furthermore, the combination of these duties with that of 
the mental inspection of school children would be practicable. A 
psychologist attached to the courts could bring about the proper 
segregation of the feeble-minded in places other than the county 
almshouse, which is so unsuitable for the purpose. 



SUMMARY. 

In all, 75 school buildings were surveyed in the rural districts of 
Porter County, 2,488 children were studied physically and 2,185 
mentally. 

SANITARY SURVEY. 

SCHOOL LOCATIONS. 

The elevation of school sites was good in 24 instances, fair in 26, 
and poor in but 9. Walks were observed at 30 schools, 12 being 
merely entrance walks. Some of the schools were located in more 
or less close proximity to nuisances. 

The average time taken by children in reaching school was 18.8 
minutes. Free transportation was practiced in 10 townships, 345 
children being transported at an annual cost of $10,729.88. 

A sanitary rating of the school privies never reached higher than 
50 per cent at any school. The majority of the privies were of the 
" pit " type. The upkeep and sanitary policing of the greater number 
of privies were bad. 

SCHOOL BUILDINGS. 

Of 75 rural schools inspected, 89.3 per cent were one-story struc- 
tures and 50.7 per cent were frame. Fifty-seven per cent were more 
than 20 years old. The basements w^ere waterproof in 16 of the 23 
schools having basements. 

Ten of the schools faced north, 23 east, 25 south, and 17 west. The 
state of repair of 43 was good, of 24 fair, and of 8 poor. No fire- 
fighting apparatus was found in any school; 5 were provided with 
fire escapes. Cloakrooms were provided in only 38 per cent of the 
schools inspected. 

WATER AND LAVATORY FACILITIES. 

The water used in 75 per cent of the schools was obtained from 
shallow driven wells; 3 schools were connected with town water 
systems and 2 had wells from 125 to 130 feet deep. Protection from 
surface drainage was not satisfactory. Sanitary drinking fountains 
of various stationary types were found in 7 schools, but were in use 
in only 4. 

Facilities for washing the hands were limited, common wash 
basins being provided m 75 per cent of the schools but not being 
in use in many. 

107 



108 BUEAL SCHOOL SANITATION. 



CLASSROOMS. 



Adjustable desks were found in 9.15 per cent of the classrooms. 
Slate was used for blackboard purposes in 85.5 per cent of the schools. 
WindoAV shades adjustable from top and bottom for the regulation 
of admission of sunlight were used in 51.5 per cent of the class- 
rooms. 

Daylight was admitted from a desirable direction in only 42.2 
per cent of the classrooms. The average ratios of window glass area 
to floor space for all schools was 15.5 per cent, the maximum being 
20 per cent and the minimum 8. 

Wainscoting was found in 50 classrooms. The walls and ceilings 
were painted too dark a green from the standpoint of illumination 
in 46 classrooms and were white in 20, undesirable because of the 
high reflection coefficient. 

HEATING. 

Closed stoves were used for heating purposes in 41.1 per cent of the 
rural schools, jacketed stoves in 34.5 per cent, and hot-air furnaces 
in 21.1 per cent. Humidification of classroom atmospheres in all 
schools was inadequate, the relative humidity being under 40 per cent 
in a majority of cases. Carbon dioxid was present in 7 classrooms 
to the extent of 8 parts per 10,000 and in 4 classrooms to the extent 
of 10 parts in 10,000. 

VENTILATION. 

Ventilation of 27.6 per cent of the classrooms depended entirely 
upon a natural circulation of air. The Plenum system of ventilation 
was employed in 20.8 per cent of the classrooms and the gravity sys- 
tem in 51.6 per cent. In most classrooms depending upon the latter 
the amount of air supply for each pupil per minute was insufficient. 
An ample provision of air space was found in practically all of the 
schools. 

PHYSICAL STATUS OF CHILDREN. 

A total of 2,488 children (1,253 boys and 1,235 girls) were studied, 
against a daily attendance of 2,512. Practically 8 per cent of the 
boys and 10 per cent of the girls were 6 years old and under, and less 
than 10 per cent of either sex were over 15 years of age. 

PHYSICAL DATA. 

1. A comparison of the mean height and weight of Porter County 
rural school children with those of children in other localities shows 
a deficiency in the former during certain age periods. In general 
the mean height and weight of children of German, Polish, and 
Scandinavian origin in the county were higher than the corre- 
sponding heights and weights for the county as a whole. - 



SUMMARY. 109 

2. The rise of limg capacity in boys from 7 to 18 was constant, 
except for a decided break between the fifteenth and sixteenth years. 
The vital capacity of girls was similar to that of boys up to the 
eleventh year, when a decline in the rate of increase commenced, be- 
coming more marked after the fourteenth year. 

3. The chest expansion of boys rose from 1 inch at the sixth year 
to nearly 4 inches at the eighteenth, while that of girls rose from less 
than 1 inch at the sixth year to 3 inches at the sixteenth, followed 
by a sharp decline. 

4. The strength of the right hand for boys increased from 9.2 to 
34 kilos from the seventh to seventeenth years ; for girls the increase 
was from 8 to 22.9 kilos. 

5. Of the boys, 35.1 per cent were dolichocephalic, 44 per cent 
mesaticephalic, and 17.8 per cent brachycephalic. Of the girls, 41.8 
per cent were dolichocephalic, 44.7 per cent mesaticephalic, and 10.5 
per cent brachiocephalic. The highest per cent of dolichocephalic 
children were Scandinavian, the highest per cent of brachycephalic 
Polish. 

6. The average respiration rate per minute of boys decreased grad- 
ually from 21.1 at the fifth year to 16.8 at the sixteenth year, to rise 
again slightly later on; the pulse rate decreased rather irregularly 
from 92 per minute to 78. For girls the average respiration rate 
decreased from 21.3 at the fifth year to 16.3 at the nineteenth year; 
the pulse rate varied markedly at different age periods, decreasing 
from 94.2 at the fifth year to 74 at the nineteenth year. 

7. Owing to parental objection, only 158 boys were examined for 
hemoglobin. Of these, 3 had a hemoglobin per cent of 75, 16 of 80, 
51 of 85, 77 of 90, and 11 of 95. Of 130 girls, 18 had a hemoglobin 
per cent of 80, 29 of 85, 70 of 90, and 13 of 95. 

8. The breakfast of 40 per cent of the total number reporting on 
this point was composed chiefly of carbohydrates (that is, bread and 
cereals), and that of practically 60 per cent was a mixed diet of 
carbohydrates and proteids. Only 15 per cent used milk, while 
57 per cent used coffee. 

DEFECTS AND DISEASES. 

Defects associated with the organs of hearing in the case of 1,253 
boys and 1,236 girls were observed in 31.2 per cent of the boys and 
28.2 per cent of the girls. Affections of the respiratory system in- 
cluding the upper air passages were noted in 35.4 per cent of the 
boys and 32.2 per cent of the girls. Defects of the visual apparatus 
were noted in 47.2 per cent of the boys and in 45.5 per cent of the 
girls. A number of these defects were of minor character. 

Impaired hearing was observed in 13 per cent of the boys and 11.3 
per cent of the girls. 



110 EUEAL SCHOOL SANITATION. 

Adenoids were present in 13.2 per cent of the boys and 9.8 per 
cent of the girls. Various grades of pharyngitis and nasal catarrh 
were observed in 39 boys and 50 girls, or 3.6 per cent of the total 
examined. Enlarged or diseased tonsils were observed in 195 boys 
and 190 girls, or 15.4 per cent of the total examined. 

Only 2 cases of tuberculosis were encountered. 

Sixty per cent of the boys and 60 per cent of the girls had some 
degree of dental defectiveness. Of the boys, 54.5 per cent and of the 
girls 44.2 per cent had two or more defective teeth. The extent to 
which dental correction had been practiced among children was 
slight up to the eighth year. The percentage of dental work increases 
from this year on, but in greater relative proportion among the girls. 
Eighteen and three-tenths per cent of the boys and 10.5 per cent of 
the girls never used a toothbrush, 57.8 per cent of the boys and 48.6 
per cent of the girls used it occasionally, and its daily use was noted 
in but 13.9 per cent of the boys and 40.9 per cent of the girls. 

Including errors of refraction, 1,335 visual defects were distrib- 
uted among 1,142 children, or not quite 1.2 defects for each child. 
The greatest number of these defects were due to errors of refrac- 
tion; astigmatism was noted in 953 children, 39.4 per cent of the 
boys and 36.3 per cent of the girls being astigmatic. Seven cases of 
trachoma were encountered. 

Goiter, or simple thyroid enlargement, was noted in 61 per cent 
of the school children. 

MENTAL STATUS. 

Children were classified as normal, retarded, and exceptionally 
retarded, the latter comprising all children with mental deficiency. 

The Binet- Simon tests were used in this survey to show the gen- 
eral mental development of the children examined. In the case of 
the exceptionally retarded children, however, special methods were 
employed to determine the mental status of each child so recorded. 

Of the 1,087 girls and 1,098 boys examined in the rural schools, 93 
of the former and 100 of the latter were below the average men- 
tally, or 8.7 per cent of the whole number. The total number need- 
ing specialized instruction was 214, or 9.3 per cent. 

Seven girls, or 0.6 per cent, were retarded in such degree that their 
mental development at adult life would not be greater than that of 
children. Of these, 28 per cent were below the mean physical devel- 
opment for the county. 

Of the boys, 1.2 per cent were exceptionally retarded. Of these, 
28.5 per cent were below the mean physical development of the 
county as a whole. Of the total school population, 0.9 per cent were 
mental defectives. The percentage of exceptionally retarded chil- 



SUMMARY. Ill 

dren recorded in the county is considerably less than that found by 
other observers in other localities. 

Of the physical defects associated with retardation, those of the 
special senses, with the exception of defective hearing, were found 
in greater proportionate numbers among children who were simply 
retarded. The exceptionally retarded children were above the aver- 
age stature of the county in greater proportionate numbers than 
retarded children. 

The undue number of one-room rural schools in the county which 
were of faulty construction, with poor equipment, and with imper- 
fect teaching facilities were largely responsible for the retardation 
found in the county. 

The average loss of grade by 193 children, as recorded by teachers, 
was 1.28 years for girls and 1.5 years for boys, a total of 269 school 
years. 

No special classes for the instruction of retarded children were 
found in any of the rural schools of the county. 

In addition to the 214 children who were retarded and excep- 
tionally retarded, 3 epileptics and twO' constitutionally inferior chil- 
dren were found among the school children of the county. 

CONCLUSIONS. 

The conclusions based on these surveys are to the following 
effect : 

(1) There is an undue number of one-room rural schools in the 
county. 

(2) An attempt has been made in the construction of the larger 
consolidated schools of the county to rectify some faults of school 
construction outlined in this survey. 

(3) Of the special causes of unfitness of school buildings for 
school purposes may be mentioned an undue number of old build- 
ings which have largely passed the limits of usefulness for educa- 
tional purposes. A number of these schools were situated in un- 
desirable proximity to nuisances; were not provided w^ith sanitary 
privies; were without a water supply; had faulty illumination of 
classrooms; were without adequate classroom equipment; were im- 
properly heated and poorly ventilated; were deficient in cloakroom 
accommodations; and presented evidences of inefficient janitor's serv- 
ice. 

(4) The large number of children presenting physical defects of 
such gravity as to demand specialized medical and surgical atten- 
tion is an evidence of the need of medical supervision of the school 
children of the county in the interests of the child's educational ad- 
vancement and for the protection of the community health. 



112 RUEAL SCHOOL SANITATION. 

(5) The undue number of mentally defective and retarded school 
children revealed by these examinations emphasizes the necessity 
of the mental classification of the children of the county for the pur- 
pose of revealing those who are in need of institutional or indi- 
vidualized treatment. 

RECOMMENDATIONS. 

The following recommendations are in harmony with the conclu- 
sions specified: 

(1) Especial effort should be made to consolidate an additional 
number of the rural schools of the county wherever this may be 
practicable. 

(2) In cases where consolidation can not be accomplished a num- 
ber of rural schools should be remodeled so as to render them sani- 
tary. 

(3) Greater attention should be given to the daylight illumination 
of a number of classrooms of the county. Windows should be re- 
arranged and the interior decorations selected to meet the require- 
ments of light diffusion most desirable for visual comfort. 

(4) All of the schools of the county should be provided with sani- 
tary privies for the protection of the school water supply and as an 
example in personal and public hygiene. 

(5) Each school in the county unconnected with a general water 
system should be provided with individual sources of water for 
drinking purposes. These should be properly protected against sur- 
face drainage. Furthermore, the practice of obtaining the water for 
school puposes from neighboring farmhouses should be discontinued. 

(6) The heating of classrooms by closed stoves should be pro- 
hibited and greater attention given to the upkeep and installation of 
heating plants. 

(7) Ventilation by the routine opening of windows should be a 
requirement, and the installation of protected openings to the out- 
side air should be provided in all classrooms heated and ventilated 
by the gravity method. 

(8) Better cloakroom accommodations should be provided in all 
schools and the use of classroom walls and entrance halls for this 
purpose prohibited. 

(9) Greater security against fire in the larger consolidated schools 
should be obtained through the installation of fire-fighting apparatus, 
properly arranged fire escapes, and the institution of regular fire 
drills. 

(10) The duties of medical inspector of schools should be com- 
bined with those of local health officer. 

(11) A full-time officer should be required to be appointed for 
the discharge of these combined duties, thereby preventing the 



RECOMMENDATIONS. 113 

spread of disease in the school and improving health conditions in 
the county. 

(12) It would be desirable for the above-mentioned officer to be 
affiliated also with the juvenile courts or other courts having jurisdic- 
tion over juvenile delinquents to make mental examinations of such 
offenders for the purpose of mental classification in the interest of 
justice. 

(13) Steps should be taken to secure institutional treatment for 
tlie mental defectives in the county. 

(14) Measures should be taken to secure special classes and in- 
dividualized instruction for children who are simply retarded and 
fail to make grade. 

38062°— 16 8 



INDEX 



Pago. 
Adenoids 80, 85, 98 

Age distribution 65 

Age of entering school . 65 

Air exchange, etc. See Ventilation. 

Air space per pupil 56 

Air washing 58 

Anemometer measurements 55, 56 

Ankylosis 82 

Astigmatism 80, 91 

Atmospheric conditions in Porter County schools 50, 51 

Attendance : 

Average daily attendance 10 

Duration 67 

Enrollment 65, footnote 

Period of compulsion 65 

Auditory defects 80, 81, 82, 83 

Backwardness. See Retardation. 

Base burner 46 

Basements : 

Daylight illumination 21 

Height of ceiling 21 

Location of toilets in basement or on classroom floors 14 

Ventilation 21 

Waterproof structure 21 

Binet-Simon tests 94, 95 

Blackboards 33 

Chalk troughs 34 

Dimensions 33 

Location 34 

Material 33 

Breakfasts of school children 79^ 80 

Brightness glare 43 

Bronchial asthma 80, 81, 86 

Bronchitis 80, 81, 86 

Buildings, . school. See School buildings. 

Bulletins on school hygiene 126 

Burial of excreta 16^ 17 

Busses, school 12, 13 

Carbon dioxide in schoolrooms 50, 54 

Catarrh, nasal 80, 85 

Ceilings : 

Color 44 

Material 45 

115 



116 INDEX. 

Page. 

Cephalic index 70-74, 76, 78 

Clialk trouglis— — 34 

Oliarts (list) 5 

Chest expansion 70-74, 76 

Children. See School children. 

Circulatory system, disturbances of 80, 81, 82 

Classification of privies 15 

Classification of normal children 97 

Classification of retarded and exceptionally retarded children- 97, 98 

Classroom equipment: 

Classroom walls 30 

Floors 30 

School desks 30 

Adjustable desks 31 

Number and arrangement of desks 32 

Window shades 32 

Blackboards 33 

Dimensions 33 

Location 34 

Chalk troughs 34 

Cloakroom accommodations 62 

Closed stove 46 

Coffee used by school children 79 

Color blindness 80, 92 

Common drinking cup 29 

Composition blackboards 33 

Compulsory attendance at Indiana schools 65 

Conclusions HI 

Consolidation of schools: 

Advantages ■ 13 

Encouraged by presence of old school buildings 22 

Free transportation foreshadows greater consolidation 13 

Gives possibility of individual instruction to retarded children 101 

Small attendance an argument for consolidation 22 

Construction of school buildings, date of 22 

Contents, table of 3-5 

Contrast glare 43 

Cup, common drinking 29 

Curvature, spinal 80, 88-89 

Cutaneous disease 80, 81, 86 

Date of construction of school buildings 22 

Daylight illumination of classrooms. See Illumination. 

Deafness 1— 80, 8S: 

Defects and diseases found. See Diseases. 
Deficiency, mental. See Exceptional retardation. 

Deformities of the extremities. . 80,81,82 

Delinquents, juvenile 105, 106 

Dental defects - - 80, 81, 86-88 

Dental work 80, 87 

Desks : 

Adjustable desks 31 

Arrangement in classrooms 32, 40 

Effect on postural defects 31 



INDEX. 117 

Desks — Continued. Page. 

Illumination 37 

Number of desks 32 

Teacher's desk (location) 41 

Diet 79-80 

Diffusion of light and avoidance of glare 41 

Description 41 

Types of diffusion 43 

Glare 43 

Regulation of intensity of illumination 45 

Diseases and defects: 

Table of defects 80 

Circulatory system 82 

Deformities of the extremities 82 

Defective hearing 82 

Nervous system 85 

Defects of nose and throat 85 

Adenoids 85 

Pharyngitis and nasal catarrh 85 

Involvement of tonsils 85 

Diseases of the lungs 86 

Diseases of the skin 86 

Defects of the teeth 86 

Malocclusion 87 

Dental work 87 

Toothbrush 87 

Oral hygiene . 88 

Speech defects 88 

Spinal curvature and faulty posture 88 

Effects of faulty posture on vision 89 

Other effects of faulty posture 89 

Hernia 89 

Defects of vision 90 

Astigmatism 91 

Hyperopia 91 

Myopia 91 

Defective color sense 92 

Trachoma 92 

Goiter 92 

Drainage of school grounds 11 

Drinking cups, common 29 

Dust: 

Measures for eliminating dust 59 

Fresh-air intakes 59 

Chalk troughs 60 

Doormats 60 

Sweeping 60 

Dusting 60,61 

Classroom cleaning 60 

Dusting 60, 61 

Dynamometer tests : 70-74, 76 

Ear. See Hearing. 

Eardrum, impairment of 80,84 

Eczema 80, 81, 86 



118 INDEX. 

Page. 

Eighth grade, number of children who finished eiglith grade 67 

Electrothermic indicators 53 

Elevation of school grounds 11 

Enrollment of Porter County schools 65, footnote 

Epileptics 104 

Equipment, classroom. Bee Classroom equipment. 
Exceptional retardation : 

Classification 97 

Associated defects 101 

Characteristics 102 

Causes 102 

Number of exceptionally retarded children 103 

Care of mental defectives in Indiana 103 

Education of feeble-minded 103 

Relation to community 104 

Excreta disposal. See Privies. 

Expansion, chest 70-74, 76 

Extremities, deformities of 80,81,82 

Family, average number of children 10 

Feeble-mindedness. See Exceptional retardation. 

Figures (list) 5 

Fire protection: 

Escapes 24 

Inclosing heating apparatus in fireproof structure 24 

Drills 24 

Arrangement of exits__ 25 

Racks for cloaks in hall a menace 62 

Floors and floor area 30,56 

Food: 

Nutrition 78 

Hemoglobin : 79 

Diet 79 

Foreign school children and those of foreign parents, mean physical 
measurements compared with those of all Porter County school 

children 70-74 

Foundations of Porter County school buildings 23 

Fountains, sanitary drinking 27 

Furnace, hot-air 48, 49, 52 

Rules governing installation 49, footnote 

Geographical description of Porter County 9 

Glare : 

Avoidance of 41 

Classification by Illumination Engineering Society 43 

Definition 43 

Glass area (window) ratio to floor space 36 

Glasses, correction by 80, 91 

Goddard, revision of Binet-Simon tests_ 95 

Goiter 80,92-93 

Grates - 46 

Gravity heating systems 48, 53 

Gravity ventilation systems 54 

Halls of classrooms, use for cloaks 62 

Hands, muscular strength of 76 



INDEX. 119 

Hearing defective: Page. 

Table 80,81 

Description 82 

Degree of impairment 83 

Association witli retardation 98 

Heating of classrooms 45 

Efficiency of different types of heating apparatus 46 

Grates 46 

Stoves 46 

Jacketed stoves 47 

Hot-air furnaces 48 

Steam and hot-water heating 49 

Temperature regulation in classrooms 50 

Measures 52 

Ventilation. Sec Ventilation. 

As cause of retardation 100 

Height and mean height 67, 67 (footnote), 68, 70-74 

Mean height Porter County school children compared to that of 

children elsewhere , 68 

Hemoglobin 79 

Hernia SO, 89-90 

Hot-water heating 49, 52 

Hot-air furnace 48, 49, 52 

Humidifiers 48 

Humidity : 

Air washing 58 

Desirable classroom humidities 58 

Effect of closed stove on humidity 47 

Measures for regulating humidity 58 

Percentages in Porter County schools (table) 50 

Use of huraidostat 58 

Humidostat 58 

Hygiene, oral 80, 88 

Hyperopia 80, 91 

Illuminating Engineering Society, classification of glare 43 

Illumination of classrooms : 

Securing an abundance of illumination 35 

Window area 36 

Visible sky vault 38 

Photometric standards 39 

Less reliable measures 39 

Position of illumination source with respect to desk arrangement 40 

Defective illumination as cause of retardation 1(X) 

Illustrations (list) 5 

Impairment of hearing, degree of 80, 83 

Impetigo 80, 81, 86 

Individual instruction : 101 

Inlets and outlets, location for purposes of ventilation 57 

Instruction. See Teaching. 

Jacketed stoves 47 

Janitor service 60, 63 

Juvenile delinquents 105-106 

L. R. S. privy 17 



120 INDEX. 

Page. 

Lavatory facilities 29 

Ligliting. See Illumination of classrooms. 

Lockers 63 

Lung diseases 80, 86 

Lung tests. See Vital capacity. 

Malocclusion 80, 87 

Mechanical ventilation 54, 55 

Mental conditions requiring supervision : 

See Retardation and exceptional retardation. 

Epileptics . . 104 

Juvenile delinquents 105 

State provision for juvenile offenders 105 

IMental deficiency. See Exceptional retardation. 

Mental grading, method of 96 

Mental status of rural school children of Porter County 94, 111 

Moisture of air. See Humidity. 

Muslin screens, use in lower window sashes for ventilation 61 

Myopia 80,91 

Nasal catarrh 80, 85 

Nationality : 

Mean physical measurements of all Porter County rural school chil- 
dren compared with foreign-born or those of foreign parents 70-74 

Nervous system 80, 85 

Normal children, classification 97 

Nose and throat defects 80,85 

Number of children studied 65 

Nutrition 78 

Hemoglobin ; 79 

Diet ^ 79 

Nutritional disturbances 98 

Odors : 

In classrooms . 61 

In cloakrooms 62 

Offenders, juvenile 105 

Oiling floors 30, 61 

Open-air schools 62 

Open fires . 46 

Ophthalmoscope, determination of myopia 91 

Oral hygiene 80, 88 

Orientation of school buildings 22 

Outlets and inlets, location of, for purposes of ventilation 57 

Ozone, use in eliminating odors from classrooms 61 

Ozonizers 61 

Paralysis - 80, 85 

Pharyngitis and nasal catarrh 80, 85 

Photometric observations and standard" 37, 39 

Physical data : 

Height and weight 67 

Mean height and weight '. 68 

Racial differences in physical development 70 

Vital capacity 74 

Chest expansion 76 

Dynamometer tests 76 



INDEX. 121 

Physical data — Continued. Page. 

Cephalic index — 76 

Pulse and respiration rate 78 

Nutrition 78 

Hemoglobin 79 

Diet 79 

Physical defects. See Diseases. 
Physical exercise : 

Importance of playgrounds 12 

"Home worlc " not a substitute for physical exercise 12 

Physical fitness of rural school children in Porter County 64-93 

Physical measurements, mean 70 

Physical status of children: 

Reasons for study 64 

Number of children studied 65 

Age of school entrants 65 

Age distribution 65 

"Pit" privy, sanitary value 15 

Playgrounds : 

Space allowance per pupil in cities 12 

Desirable area in rural communities 12 

Plenum system of ventilating 57 

Population figures, Porter County 10 

Population, school, of Porter County 10 

Posture, faulty : 

Effect of defective illumination 35 

As cause of spinal curvature 88, 89 

Effects on vision SO, 89 

Other effects 80, 89 

Privies and soil pollution : 

Protection from soil pollution 13 

Inside toilets 13-15 

Location of inside toilets 14 

Number of toilet seats 14 

Toilet plumbing and other considerations 14 

Inside toilet construction 14 

Outside toilets or privies 15 

Classification of privies 15 

Sanitary privies 16-17 

Burial of contents 16-17 

Distance of privy from water supply and from school buildings 18 

State of repair and maintenance of privies 18 

Location of wells in relation to privies 26 

Proximity of Porter County schools to nuisances 11 

Psychologist, attached to court 106 

Publications by service on school hygiene 126 

Pulse and respiration, rate 78 

Racial differences in physical development 70 

Racks for cloalis 62 

Recommendations 112 

Reformation of juvenile offenders 105 

Refraction, faulty 80, 90 

Related publications 126 



122 INDEX. 

Page. 

Repair of school buildings : 23 

Respiration rate 78 

Retardation : 

Classification 97 

Defects associated with retardation 98 

Other causes of mental retardation 100 

Care of retarded children 101 

Retarded children, exceptionally. See Exceptional retardation. 

Ringworm of the scalp 80, 81, 86 

Roofing of Porter County schools 23 

Sanitary privies 16 

Sanitary survey of rural school locations and buildings 9-63 

Sawdust, moist, use in cleaning classrooms 61 

School buildings: 

Number and construction 20 

Number of stories 21 

Basements 21 

Orientation of buildings 22 

Date of construction 22 

Foundations . . 23 

Roofing 23 

State of repair 23 

Fire protection . 23 

Poorly equipped schools as cause of retardation 100 

School children, average number in a family in Porter county 10 

School desks 30-31 

School locations 10 

Requirements 11 

Elevation 11 

Drainage 11 

Wells 1— 11 

Shade 11 

Proximity to nuisances 11 

Accessibility to school population 12 

Transportation of school children 13 

School population of Porter County 10 

Seats, toilet, number of and height 14 

Shade, of schools 11 

Shades, window 32, 45 

Simon and Binet tests 94-95 

Site, school 10 

Skin diseases 80, 81, 86 

Sky vault, visible, in illimiination of classrooms 38 

Slate : 

Use for blackboards 33 

Liquid slate 33 

Snellen chart visual test readings—^ 90 

Sociological data 10 

Soil pollution. See Privies and soil pollution. 

Sources of water supply 25 

Specular reflection 43 

Speech defects ^— 80, 88 



INDEX. 123 

Page. 

Spinal curvature and faulty posture 80, 88, 89 

Spirometer tests. See Vital capacity. 

Stammering 80,88 

Steam heating 49, 52 

Stories, number of in Porter County school buildings 21 

Stoves 46 

Summary i 107 

" Surface" privies 16 

Sweeping : 

Dry sweeping 61 

Compounds 61 

Tables (list) 4, 5 

Talquist, von, scale used in hemoglobin tests 79 

Teacher's desk, arrangement of 41 

Teaching : 

Relation to retardation 100 

Individual instruction for retarded children 101 

Teeth, defects of: 

Table 80, 81 

Number of children affected 86 

Malocclusion 87 

Dental work 87 

Use of toothbrush 87 

Oral hygiene 88 

Association with mental retardation 98 

Temperature : 

Regulation in classrooms 50 

Keeping rooms cold for anemic children, etc 61 

See also Heating. 

Throat, defects of 80,85 

Thyroid enlargement 80, 92, 93 

Toilets, inside: 

Location 14 

Number of toilet seats 14 

Plumbing 14 

Construction 14 

Toilets, outside. See Privies. 

Tonsils, enlarged 80, 85, 98 

Toothbrush, use of 80,87 

Trachoma 80, 92 

Transportation : 

Time taken by children in going to and from Porter County schools. _ 12 

School busses 13 

Foreshadows greater consolidation of schools 13 

Tuberculosis 80, 81, 86 

Unilateral window arrangements in classrooms 40 

Vault, visible sky, in illumination of classrooms 38 

Veiling glare 43 

Ventilation of classrooms 53 

General considerations : : 53 

Changes of air 54 

Supply of air necessary for classroom purposes 54 



124 INDEX. 

Ventilation of classrooms — Continued. 

General considerations — Continued. Page. 

Methods of securing requisite air allowance 54 

Mechanical ventilation 55 

Rate of air exchange 55 

Air space per pupil 56 

Inlets and outlets 57 

Humidity 57 

Desirable classroom humidities 58 

Measures for regulating humidity 58' 

Use of humidostat 58 

Air washing 58 

Dust 59 

Dust and other impurities 59 

Measures for eliminating dust . 59 

Fresh-air intakes 59 

Chalk troughs 60 

Door mats 60 

Sweeping 60 

Dusting : 60 

Classroom cleaning in Porter County schools 60 

Elimination of odors from classrooms 61 

Other measure for securing outside air conditions for schools — 

Use of muslin screens in windows 61 

Cold rooms 61 

Open-air schools 62 

Advantages of jacketed stove for purposes of ventilation 47-48 

Poor ventilation as cause of mental retardation 100 

Visible sky vault in illumination of classrooms 38 

Vision, defects of 80, 90-92, 98 

Von Talquist scale used in hemoglobin tests 79 

Wainscotings ; 45 

Walks 11 

Walls of classrooms : 

General considerations 30 

Coloring to prevent glare 44 

Used for hanging wraps 62 

Washing hands, facilities for . : 29 

Water containers . 27 

Water supply and lavatory facilities : 

Distance of privy from water supply 18 

Sources of supply 25 

Driven wells , 26 

Protection from subdrainage 26 

Water containers . 27 

Facilities for washing hands 29 

Use of common drinking cup 29 

Weight and mean weight 67, 67 (footnote), 68, 70-74 

Mean height and weight of Porter County children compared to that 

of children in other sections 68-70 

Wells : 

Shallow wells 25 

Driven wells 26 



INDEX. 125 

Wells — Continued. Page. 

Location 26 

Protection from surface drainage 26 

Windows, classroom : 

Window areas 36 

Arrangement '. 40 

Shades 32,45 

Wood, use for blackboards 33 

Wraps, accommodations for 62 



RELATED PUBLICATIONS. 

(Literature bearing upon school hygiene issued by the U. S. Public 
Health Service, from which copies may be obtained without charge.) 

PUBLIC HEALTH BULLETINS. 

52. Vaccination. An analysis of the laws and regulations relating thereto in 
force in the United States, containing court decisions and a summary of 
some foreign vaccination laws. By J. W. Kerr. January, 1912. 

58. Open-air schools for the cure and prevention of tuberculosis among children. 
By B. S. Warren. October, 1912. 

62. Communicable diseases. An analysis of the laws and regulations for the 
control thereof in force in the United States. By J. W. Kerr and A. A. 
Moll. July, 1913. 

EEPEINTS FKOM THE PUBLIC HEALTH EEPOKTS. 

101. Trachoma in Kentucky. Reports of investigations into the prevalence of 
trachoma in the mountains of eastern Kentucky. By John McMuUen. 
Nov. 8, 1912. 

116. Country Schools and Rural Sanitation. Six sample public schools in one 
county. Does this county need medical inspection in its schools? The 
country school-teacher. By Ch. Wardell Stiles. Feb. 7, 1913. 

118. Snuff and Tobacco. Their use by school boys and girls in county Z. By 
Ch. Wardell Stiles and S. B. Altman. Feb. 28, 1913. 

142. Medical Inspection of Schools. A lecture delivered at the Summer School 

of the South University of Tennessee, Knoxville, Tenn. By J. W. 
Schereschewsky. Aug. 29, 1913. (Reprint No. 142 may be obtained only 
from the Superintendent of Documents, Washington, D. C, at a cost df 
5 cents.) 

143. Trachoma. Its prevalence and control in the public schools of Cebu. By 

Louis Schwartz. Sept. 12, 1913. 

144. School Hygiene. Report of the meeting of the Fourth International Con- 

gress on School Hygiene, Buffalo, N, Y., Aug. 25-30, 1913. By J. W. 
Schereschewsky. Oct. 3, 1913. 

177. Rural Schools. Sanitary survey of schools in Bartholomew County, Ind. 
By J. A. Nydegger. Feb. 6, 1914. 

184. Endemic Goitre. Its possible relationship to water supply. By Taliaferro 
Clark and Claude C. Pierce. April 17, 1914. 

196. Trachoma in Kentucky. A report of a sanitary inspection of the schools 
of Jefferson County, Ky., with special reference to the prevalence of 
trachoma. By J. H. Oakley, Dunlop Moore, and Lawrence Kolb. 
May 29, 1914. 

198. Trachoma. A survey of its prevalence in the mountain sections of Vir- 
ginia and West Virginia. By Taliaferro Clark. July 5, 1914. 

207. Trachoma. A survey of its prevalence in the mountain sections of North 
and South Carolina. By A. D. Foster. July 10, 1914. 
126 



EURAL SCHOOL SANITATION. 127 

211. School Hygiene. A report of a sanitary survey of scliools and of medical 
inspection of school children in certain sections of North and South 
Carolina, By A. D. Foster. July 31, 1914. 

219. The Hygiene of Rural Schools. By Taliaferro Clark. Sept. 11, 1914. 

220. Trachoma. A survey of its prevalence in the mountain sections of east 

Tennessee and northern Georgia. By Charles A. Bailey, Sept. 18, 1914. 

236. Mental Deficiency. Some of its public health aspects, with special refer- 

ence to diagnosis. By E. H. Mullan. Nov. 27, 1914. 

237. School Hygiene. A report of the sanitary inspection of rural schools of 

east Tennessee and northern Georgia. By Charles A. Bailey. Dec. 4, 
1914. 

241. Trachoma in the Schools of Porto Rico. By W. W. King. Dec. 18, 1914. 

263. Trachoma. A survey of its prevalence in the mountain section of eastern 
Kentucky. By John McMuUen. March 5, 1915. 

286. Zooparasitic Intestinal Infections. An analysis of infections found among 
1,287 school children (776 white, 511 negro) of the city of X. By 
C. W. Stiles. July 2, 1915. 

288. Intestinal Infections. The school grades attained by 2,166 white school 
children (1,062 boys, 1,104 girls) in the city of X, classified by age, 
sanitation, and intestinal parasites. By C. W. Stiles. July 2, 1915. 

301. Tobacco and Snuff. Their use by white school children in the city of X. 
By C. W. Stiles and D. N. Richards. Oct. 1, 1915. 

303. Heights and Weights of Children. Classification, by age and by sanita- 
tion, of 1,652 white school children (771 boys, 881 girls) in the city 
of X. By C. W. Stiles and George A. Wheeler. Oct. 8, 1915. 

306. Lung Capacity of Children. Spirometer tests of 1,618 white school chil- 
dren (751 boys, 867 girls) in the city of X. C. W. Stiles and Floyd 
Graves. Oct. 15, 1915. 

SUPPLEMENTS TO THE PUBLIC HEALTH REPOETS. 

6, Contagious Diseases. Their prevention and control in children's institu- 
tions. By James P. Leake. April 11, 1913. 

18. Malaria — Lessons on its cause and prevention. (For use in schools.) By 
H. R. Carter. July 17, 1914. 

25. School Hygiene. Survey of schools in Manatee County, Fla. By J. A. 
Nydegger. July 30, 1915. 

o 



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